Public Release: 

ACR opposes sweeping healthcare cuts in Trump administration budget

American College of Rheumatology

ATLANTA - The American College of Rheumatology (ACR) today expressed opposition to the Trump Administration's proposed budget cuts to federal programs and institutions that provide critical resources in the fight against rheumatic diseases, including the National Institutes of Health (NIH), the U.S. Food and Drug Administration (FDA), and the Children's Health Insurance Program (CHIP). The rheumatology provider community praised budget proposals to repeal the Independent Payment Advisory Board (IPAB) and to increase funding for Graduate Medical Education (GME) programs.

"Unfortunately, the Administration's proposed 2018 budget would slash vital funding for institutions and agencies that, together with rheumatology providers, are on the frontlines of rheumatic disease prevention and care," said ACR President Dr. Sharad Lakhanpal, MBBS, MD. "At a time when one in four U.S. adults now live with painful and debilitating rheumatic diseases, it is imperative that the federal government provide stable, predictable funding for the medical research and regulatory activities that lead to more affordable and effective treatments for Americans living with these diseases."

The President's proposed FY 2018 budget would cut NIH funding by $6 billion, reduce taxpayer funding for the FDA by $854 million, and cut CHIP program funding by $4.8 billion.

"NIH funding cuts would threaten jobs and our nation's status as a leader in medical innovation while slowing down life-saving research that leads to better prevention strategies and new treatments for arthritis, rheumatic diseases and their comorbidities," said Lakhanpal. "We applaud Congressional leaders on both sides of the aisle who supported the $2 billion NIH funding increase for FY2017. We urge Congress to again come together in bipartisan support for medical research advances that improve the lives of all Americans, by including a funding increase for NIH in the 2018 budget."

The ACR also expressed concern about the proposed reduction in taxpayer funding for FDA regulatory activities.

"The ACR supports increased FDA funding to bolster the agency's biosimilar drug review and approval process, which we believe is key to improving competition and lowering the cost of effective but expensive biologic therapies," Lakhanpal said. "While we recognize the proposal to replace nearly a billion dollars in cuts to the taxpayer funded FDA budget by increasing industry user fees, we are concerned that this funding may not materialize given that this year's user fee agreements have already been negotiated. Overall, we fear that the proposed reduction in taxpayer funding for FDA activities could slow the regulation and advancement of new biosimilars and hamper efforts to make these therapies more affordable for our patients."

Rheumatology leaders also expressed opposition to proposed cuts to Medicaid and CHIP, which are a critical safety net for vulnerable patients.

"Rheumatic diseases do not discriminate based on age. Approximately 300,000 U.S. children live with doctor-diagnosed arthritis, and the CHIP program helps ensure children in families with incomes too high to qualify for Medicaid can get free or low-cost care," said Lakhanpal. "Without this support system, many children living with arthritis would go without life-saving care."

The ACR expressed support for a Medicare provision included in the budget proposal, regarding the recommendation to repeal the Independent Payment Advisory Board (IPAB).

"An appointed panel with sweeping authority to impose arbitrary payment cuts is not the appropriate way to curb health care spending," said Lakhanpal. "The risk of harm is too great when responsibility for Medicare decisions is mired in additional levels of bureaucracy, particularly one that is immune from Congressional oversight and not accountable to all stakeholders. Therefore, the ACR applauds the budget recommendation to repeal IPAB once and for all. We were further encouraged to see the Administration's budget proposal provides resources and signals a commitment reform the Medicare appeals process, which is long overdue."

The effects of the budget proposal on the future supply of rheumatologists would be mixed. In order to fulfill its goals of improving and expanding access to care, the ACR strongly endorses additional funding for graduate medical education (GME), as well as other broad measures to increase the supply of rheumatologists. The ACR was supportive of the budget's proposed increases in funding for GME, which is a crucial step in shoring up deficiencies in the healthcare workforce. However, the ACR strongly criticized the proposed elimination of the Public Service Loan Forgiveness program, which could reduce the supply of doctors where they are most needed.

"The ACR will continue to provide feedback to the Administration and Congressional leaders as they work to craft a budget that meets the healthcare needs of all Americans, including the 54 million individuals who live with arthritis and other rheumatic diseases," Lakhanpal concluded.

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The American College of Rheumatology (ACR) is the nation's leading advocacy organization for the rheumatology care community, representing more than 9,500 rheumatologists and rheumatology health professionals. As an ethically driven, professional membership organization committed to improving healthcare for Americans living with rheumatic diseases, the ACR advocates for high-quality, high-value policies and reforms that will ensure safe, effective, affordable and accessible rheumatology care.

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