AAMC (Association of American Medical Colleges) President and CEO David J. Skorton, MD, issued the following statement in response to President Trump’s FY 2021 budget request, which proposes drastic decreases to nondefense discretionary spending, including the National Institutes of Health (NIH), the Health Resources and Services Administration (HRSA), and other health agencies. The budget also proposes to cut Medicare funding for graduate medical education (GME) and Medicaid payments; to eliminate Public Service Loan Forgiveness (PSLF); and to undermine the 340B Drug Pricing Program.
“The AAMC is very concerned about the administration’s proposed budget and its effects on the health of the nation. If implemented, the budget would be devastating for patients and their families, derailing critical progress on new cures, prevention, and treatments for disease. The proposed budget also would ravage America’s health care workforce infrastructure and dismantle the health care safety net.
The $3 billion in cuts proposed to NIH-funded research, most of which occurs at medical schools and teaching hospitals, would thwart scientific progress on strategies to prevent, diagnose, treat, and cure medical conditions that affect countless patients nationwide. The federal investment in NIH to date has resulted in decreasing death rates from cancer and heart disease, treatments for HIV/AIDS, and new approaches for treating substance use disorder, among other advancements. This crucial funding also provides the starting place for hope for patients suffering from serious illnesses such as diabetes, Alzheimer’s disease, and depression. We must continue the bipartisan budget trajectory set forth by Congress over the last several years, not reverse course.
The negative consequences of the potential decreases in NIH funding are compounded by dramatic proposed cuts to other research and public health programs, including the Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention. Further, the proposal to eliminate GradPLUS, PSLF, and certain HRSA workforce programs would limit the nation’s ability to recruit and retain a diverse and culturally competent health care workforce and meet the needs of rural and other underserved communities.
Likewise, the president’s proposal to reduce and consolidate Medicare, Medicaid, and Children’s Hospital GME into a single grant program would exacerbate the projected physician shortage by forcing teaching hospitals to absorb $52 billion in untenable cuts. The proposal ignores the intent of the Medicare GME program, which is to ensure an adequate physician workforce to care for Medicare beneficiaries and support the critical patient care missions of America’s teaching hospitals. Dramatically reducing this essential federal investment in the missions of teaching hospitals would mean fewer physicians and decreased access to care for patients, including access to potentially critical services.
At the same time, the massive cuts to Medicaid included in this budget request, in addition to the administration’s recent proposals to scale back Medicaid coverage, would result in reductions in coverage, access, and high-quality care for the millions of vulnerable patients who rely on this program to receive the health care they need. More than 26% of all Medicaid hospitalizations occur at AAMC-member teaching hospitals, even though these institutions represent only 5% of all hospitals. Each of the administration’s proposals on their own would be devastating for patients – and combined, they would be disastrous.
Separately, while the AAMC agrees that the high price of prescription drugs needs to be addressed, undermining the critical 340B program – which is not taxpayer funded – is not the way to do it.
The AAMC encourages Congress to reject these proposals that will be harmful for patients across the country. Instead, we urge lawmakers to continue to work in a bipartisan manner to invest fully in the research, education, and patient care programs that advance discovery, promote the nation’s health care workforce, and strengthen the health care safety net for all.”
The Association of American Medical Colleges is a not-for-profit association dedicated to transforming health care through innovative medical education, cutting-edge patient care, and groundbreaking medical research. Its members comprise all 154 accredited U.S. and 17 accredited Canadian medical schools; nearly 400 major teaching hospitals and health systems, including 51 Department of Veterans Affairs medical centers; and more than 80 academic societies. Through these institutions and organizations, the AAMC serves the leaders of America’s medical schools and teaching hospitals and their 173,000 faculty members, 89,000 medical students, 129,000 resident physicians, and more than 60,000 graduate students and postdoctoral researchers in the biomedical sciences. Additional information about the AAMC and its member medical schools and teaching hospitals is available at www.aamc.org.