Congressional Corner




Feb. 15, 2018

President’s Budget

On Monday, the White House released President Trump’s proposed FY19 budget, “Efficient, Effective, Accountable: An American Budget.” The budget outlines the Administration’s funding priorities for the upcoming fiscal year. Congress has the authority to approve, reject, or modify the budget’s recommendations. While the FY19 budget includes a multi-billion dollar proposal to address the opioid epidemic, it also proposes cuts to many federal agencies and programs. Read ASTHO’s statement on the president’s budget here.

ASTHO’s detailed analysis for CDC, HRSA, SAMHSA, and other agencies can be read here. It is important to note that it is extremely challenging to compare funding levels without congressional justifications. In addition, there are many documents circulating with different allocations and funding levels. For additional information, ASTHO recommends reading our detailed budget summary and the HHS budget in brief.

CDC also released its funding table and a one-page factsheet about the FY19 President’s Budget. These documents can be viewed here. The agency has not released a detailed congressional justification.

On Feb. 14, ASTHO hosted a call for its members to review the President’s budget request. A recording will be posted soon and more information will be available in the Public Health Weekly.

FY18 White House Request

The White House Office of Management and Budget (OMB) submitted an additional list of items it would like to see with new non-defense discretionary funding provided in the Bipartisan Budget Act that was not reflected in its original budget proposal.

The add-on document adds $352 million for the CDC, bringing its new level to $4.769 billion.

CDC ($ in thousands)

  • 2017 Enacted: 5,719
  • 2018 Budget: 4,417
  • 2018 add: +352
  • 2018 new level: $4,769 (also less than what Congress has proposed)

Per OMB’s statement, "this addback restores infectious disease (HIV, hepatitis, STD, and tuberculosis) activities, opioid activities, and emergency preparedness grants to the FY17 enacted level. This also provides a total of $30 million for CDC's Buildings and Facilities account to support ongoing maintenance activities to match the FY19 budget request."

View the full add-on document here.

Spending Guidelines for HHS

It is expected that Appropriations Committee leaders will soon reach an agreement on how to split $63 billion in non-defense discretionary spending for FY18. Rep. Tom Cole (R-OK), chair of the Labor, Health and Human Services, Education Appropriations Subcommittee says he expects a “substantial” increase above the $156 billion with which they were working.

There is no official deadline for release of these numbers, but there is preference to have them done by the end of the week. The current continuing resolution to fund the federal government expires on March 23.

Drug Czar

The White House appointed James Carroll to serve as deputy director and acting director of the Office of National Drug Control Policy.

Azar Hearings on HHS Budget

HHS Secretary Alex Azar attended hearings this week with Senate Finance and House Energy and Commerce and Ways and Means committees to discuss the President’s 2019 budget proposal. Discussions ranged from ACA enforcement, repealing and replacing ACA, Medicare payments, Medicaid cuts, cuts to the Ryan White HIV/AIDS program, and opioid funding. In yesterday’s testimony to the Ways and Means Committee, Azar emphasized the need to give states flexibility as they seek to keep costs low, especially for programs like reinsurance that can vary greatly from state to state.