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Trump Budget Proposal Could Have Health IT Implications


It calls for substantial cuts to HHS divisions that oversee patient data privacy and interoperability initiatives.

Under the Administration’s new proposed budget, the Department of Health and Human Services (HHS) would face a $17.9 billion, or 21%, decrease in funding.

According to the HHS’s own budget planning document, the Office for Civil Rights (OCR) would see an $8 million reduction in annual funding under the new budget, from $39 million in 2017 and 2018 to $31 million in 2019. The OCR, tasked with enforcing federal civil rights laws, also enforces HIPAA-related data privacy measures, assessing fines for the negligent handling of health information. The agency would likely lose staff, despite recently announcing the addition of a Conscience and Religious Freedom Division.

The Office of the National Coordinator (ONC) would see a more substantial cut: Over a third of its overall budget, dropping from $60 million this year to a proposed $38 million next. ONC is responsible for overseeing several key healthcare IT initiatives, like 21st Century Cures Act implementation and the Office of Interoperability and Standards.

Cuts to both agencies would likely result in reduced staffing, and could hurt the federal government’s ability to oversee and enforce health IT policies.

The budget does place an emphasis on combatting the opioid epidemic. “The Budget reflects a solemn and unshakable commitment to liberate communities from the scourge of opioids and drug addiction,” it reads.

The administration requests $5 billion in new resources for HHS over the next 5 years, including $50 million for a media campaign, $625 million for States to respond to the crisis, and $50 million to improve first responder access to overdose-reversal drugs, among other provisions. It would also move the High Intensity Drug Traffic Areas (HIDTA) program from the Office of National Drug Control Policy to the purview of the Drug Enforcement Administration.

The National Institutes of Health, which many feared would see a substantial cut under the previous budget, actually would see an increase under this proposal: An additional $1.4 billion, much of which would be meant to fight opioid addiction or mental illness. The Agency for Healthcare Research and Quality, the National Institute on Disability, Independent Living and Rehabilitation Research, and the National Institute for Occupational Safety and Health would all be folded into the NIH as part of the proposal.

“The Budget saves taxpayer dollars and helps move toward the President’s vision of an accountable Government that is effective and efficient in its delivery of programs,” the document states.

It’s important to note that a Presidential budget is a series of policy suggestions, rather than policy itself. It is common for elements of budget proposals to go ignored, as many of last year’s budget’s proposed cuts to health and sciences programs did.

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