FY 2018 Budget and Appropriations Update
The Trump Administration released its FY 2018 budget, A New Foundation for American Greatness, on Tuesday, May 23. The budget calls for a funding level of $6.15 billion for WIC in FY 2018 coupled with a $1.0 billion rescission of unspent funds, leaving WIC with a net funding level of $5.15 billion in FY 2018.* While this funding level is significantly less than FY 2016 and 2017, we expect that it will be sufficient to meet projected caseload needs in FY 2018. This is largely because average monthly food costs are relatively flat, food cost inflation is low, cost containment strategies have helped reduce program costs, rebates are among their highest levels, and WIC participation continues to lag.
The budget also provides $60 million for breastfeeding peer counselors and $13.6 million for infrastructure.
While WIC funding may prove adequate, the President’s FY 2018 budget, if enacted, and taken as a whole, would have significant adverse impacts on WIC families. The administration proposes to cut $1.4 trillion over 10 years from discretionary spending, including damaging cuts to funding for nutrition and healthcare, housing assistance, drug and alcohol abuse prevention, HIV/AIDS prevention, disability support, infectious disease outbreak response, reproductive health services, education, and biomedical research. The proposed deep cuts to SNAP of $192 billion, Medicaid of over $800 billion, and other programs for low-income families slashed by $272 billion could undermine WIC’s effectiveness as a supplement to other income and benefits programs. WIC’s benefits and services would be seriously undermined by these cuts and could not begin to compensate for the dire consequences and level of privation that WIC families would experience were the President’s budget adopted.
Fortunately, the budget faces significant opposition from both moderate Republicans and all Democrats who believe that the discretionary cuts are far too large and would disproportionately harm the poor and vulnerable. It is now up to members of the Appropriations Committees in the House and Senate to decide how to fund government programs in FY 2018. Many Appropriators have said that they will not heed the President’s budgetary requests. The budget has also been roundly opposed by scientists and public health advocates.
While the president's budget is unlikely to pass as proposed, it does provide a baseline from which negotiations may begin. The next step in this process is for leaders in the Budget Committees in the House and Senate to assign 302(a) spending levels, which represent the top line numbers for all discretionary spending. From there, appropriators will set 302(b) allocations, which represent what each Appropriations subcommittee—including the Agriculture Subcommittee, which sets funding for WIC—will be allocated. Democrats on the Senate Appropriations Committee said they expect bipartisan discussions to get under way this week about spending levels for FY 2018. We will keep you informed of the FY 2018 appropriations process as it proceeds.
Affordable Care Act Repeal Update
The nonpartisan Congressional Budget Office (CBO) released their score of the revised Affordable Care Act (ACA) replacement bill, also known as the American Health Care Act (AHCA) on May 24. CBO revealed in their score that the AHCA will leave 23 million more people uninsured by 2026 than if the ACA remained in place. More than half of that increase in the uninsured — 14 million — would come from reduced Medicaid enrollment. AHCA would also reduce the deficit by $119 billion over 10 years. The deficit reductions under AHCA would largely come from cuts to Medicaid and subsidies for individual health insurance. Medicaid faces $834 billion in cuts under this legislation, while the bill includes $276 billion in cutbacks in individual health insurance subsidies.
The CBO found that AHCA could make obtaining health care insurance prohibitively expensive for some sicker Americans, because under the legislation states could get waivers exempting the state’s insurers from the requirement to cover essential health benefits such as mental health and prescription drugs. States could also get waivers under AHCA that allow insurers to charge more for people with pre-existing conditions. For residents of states that opt to obtain these waivers, medical care could become prohibitively expensive (especially for people who are pregnant, addicted or have mental health issues).
It should be noted that the cuts to Medicaid and individual subsidies are partially offset by bigger costs associated with AHCA, including the repeal of many Affordable Care Act taxes. These tax cuts would overwhelmingly benefit the highest-income Americans.
Now that AHCA has passed the House, it is now under consideration in the Senate. Should it pass the Senate, the legislation is unlikely to look much like the House-passed bill. In fact, a 13-member healthcare working group (composed entirely of Republicans – all of them men) is working to write the Senate’s own version of the bill.
*The President’s proposed FY 2018 funding level was based on an assumption that FY 2017 funding would be at the continuing resolution (CR) level rather than the level provided in the FY 2017 consolidated appropriations law (“Omnibus”) now in place. The upshot? A required technical correction to reflect the FY 2017 Omnibus. This should nevertheless leave the proposal adequate to meet caseload needs.