On Monday, February 12, 2018 President Trump released his fiscal year (FY) 2019 Budget Request to Congress. This is the proposal that the Administration provides the Congress as they will develop the FY 2019 appropriation including funds for the Indian Health Service and other health programs serving Indian Country. It will be up to Congress to make any final spending decisions about appropriations for FY 2019, which will begin onOctober 1, 2018.
Currently, full details of the President’s Budget have not been released. However, there are other documents available that contain an overall picture of the FY 2019 President’s Budget. To access the 160-page budget summary document click here. To access the “Budget in Brief” for the Department of Health and Human Services (HHS) click here.
The Indian Health Service (IHS) would receive an 8% increase over the current FY 2018 budget, but the proposal still cuts or eliminates several important programs at IHS (more on IHS below). Overall, the president’s budget request eliminates $3.6 trillion from domestic spending programs including for Medicare, Medicaid, public health and social safety net programs. Many of these programs are at HHS which, as a whole, would take a 21% cut in the President’s budget. For example, the proposed budget would eliminate the Low Income Home Energy Assistance Program (LIHEAP) which is currently funded at $3.4 billion. It would also eliminate the Agency for Healthcare Research and Quality ($324 million) because the Administration claims that the functions of the agency are already being done by the National Institutes of Health (NIH). Click here to see an infographic of the cuts to HHS in the FY 2019 Budget Request.
The budget would also make major changes and cuts to the Supplemental Nutrition Assistance Program (SNAP) which would cut 22% of the program and $213.5 billion over the next decade. The proposal also would redesign SNAP by using a portion of benefits to buy and deliver a package of commodities to SNAP households, noting that it would utilize the government’s buying power to obtain common foods at lower costs. Approximately 25% of AI/AN households current utilize SNAP, but in some Tribal communities over 50% of households are recipients of the program.
It is important to note that this is just the first step in the annual appropriations process. It will be up to Congress to decide the actual FY 2019 federal appropriations. Last year, Congress proposed increases for the Indian Health Service despite the Trump Administration proposing a $300 million cut.
