San Francisco Community Health Center
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May 31, 2017

President Trump’s FY 2018 Budget and its Impact on Health, Wellness, and Equality for Vulnerable Communities
By Lance Toma, CEO of API Wellness

Last week, the Trump administration released its budget for FY 2018. The document marks a disturbing departure from the three foundational pillars of health care reform established by the Affordable Care Act (ACA): (1) improving the experience of care, (2) improving the health of populations, and (3) reducing per capita costs of health care. For API Wellness, a self-identified LGBTQ and people of color-focused community health center (CHC), this departure is an alarming call to action for San Francisco and the nation.

API Wellness primarily serves the most vulnerable communities in San Francisco—people of color, immigrants, the homeless, and the LGBTQ community. These populations have been historically marginalized and refused access to care. Yet, we know they deserve the triple aim of the ACA (see above) as much as anyone else. The President’s current budget proposal will make it impossible for our communities to achieve health, wellness, and equality.

Overall, the FY 2018 budget not only proposes deep cuts to public health, medical research, and HIV funding, but also wages war on the health of women, racial/ethnic minorities, and the poor. You’ve probably heard of the attack on the Title X Family Planning Program that essentially shortchanges women’s health clinics by $451 million, or 61%, of the $737 million required to meet the health needs of 2.5 million uninsured low-income women. You might not have heard that Trump’s budget also reduces the Office of Minority Health’s funding by $10 million, completely eliminates the HHS Secretary’s Minority AIDS Initiative Fund, and decreases the CDC’s budget for “Racial and Ethnic Approaches to Community Health” by $51 million. This is not a budget that prioritizes vulnerable communities.

Perhaps most stunning of all, the FY 2018 budget calls for a fundamental restructuring of Medicaid that is projected to cut $600 billion from the program over the next ten years. Coupled with the American Health Care Act recently passed by the House, this could result in $1.434 trillion in total cuts to Medicaid (the AHCA proposes cutting $834 billion over the same decade). Medicaid is an essential component of the healthcare safety net and plays an enormous role in reducing health disparities for communities of color (19% of non-elderly Medicaid recipients are African American and 31% are Latinx). Cuts like these would be disastrous for community health centers like ours that are at the center of our nation’s healthcare safety net.

As its name suggests, “A New Foundation for American Greatness,” is a budget that, at its core, attempts to rewrite our values as Americans and our value as human beings. The budget as proposed returns us to a time of privileged hierarchy, where the spoils of the rich are prioritized at the expense of the poor. We’re better than this and we demand a new and better budget.

Our communities need access to quality health care. To continue to make this happen, we need an appropriate budgetary response to keep us moving toward our three foundational pillars: care, populations, and cost. At the very least, our nation’s budget should hold harmless the budgets for the CDC, NIH, CHCs, Title X, and Medicaid.
As the budget makes its rounds in Congress, we must be steadfast in protecting the health of our communities. We must fight this budget and the values it represents. We transform lives by advancing health, wellness, and equality. This budget is in violation of our values. Please join me in urging your Members of Congress to protect the funding for programs that keep our communities safe.

To find your Members of Congress:

API Wellness will continue to fight for health, wellness, and equality in the FY 2018 federal budget. Stay connected to see the latest on our advocacy efforts and recommendations.