PROPOSED NATIONAL BUDGET AND HEALTHCARE REFORM EFFORTS IMPACT NEONATAL NURSES AND THEIR PATIENTS
In March, President Trump released an abbreviated version of the proposed federal fiscal year 2018 budget (America First-A Budget Blueprint to Make America Great Again). The proposed budget identifies numerous changes in funding priorities that are of high relevance to nurses and other healthcare providers. The budget approval process involves examination, negotiation, and revision of items in the proposal by September 30, 2017, to fund the government for fiscal year 2018. This process is directly and indirectly responsive to input from advocacy groups, such as NANN's Health Policy and Advocacy Committee. Of particular interest to NANN members are the following budget recommendations:
Funding for substance abuse treatment programs. The proposed budget includes enhanced funding for substance abuse treatment services for Americans struggling with substance abuse disorders. While not specifically targeted for maternal-infant-child populations, congressional approval of this budget item can be expected to broadly grow substance abuse research and programming and thereby provide response to the epidemic of opioid exposure that neonatal providers are encountering.
Funding for health professions and nursing workforce programs. To meet funding requirements in other priority areas (such as defense, homeland security, and Veterans Affairs), the proposed budget recommends cuts to the health professions and nursing workforce training programs. Proposed cuts to the Department of Health and Human Services totaling more than $400 million and to the National Institutes of Health (NIH) of 20% percent will reduce or defund certain training programs that currently strengthen the healthcare workforce and are currently supported by these institutes.
Funding for biomedical and healthcare research. In addition to supporting training programs for the healthcare workforce, the NIH is our nation's leading organization funding biomedical research. Biomedical research funding is therefore also targeted for reduction. It is through NIH funding that high-level research has been supported to develop many of our most efficacious current therapies such as antenatal steroids and high-frequency ventilation. The NIH has enjoyed bipartisan support as the global leader in healthcare innovation. The proposed funding cut of 20% (amounting to approximately $6 billion) is therefore expected to be negotiated during the budget approval process.
NANN MEMBERS SENSE A PAUSE IN SCOPING HEALTHCARE REFORM AFTER AMERICAN HEALTH CARE ACT IS WITHDRAWN
Repeal of the Affordable Care Act (ACA, or "Obamacare") appears to be on hiatus following a March withdrawal of the Republican-backed American Health Care Act from consideration by Congress. Input from nurses, other healthcare providers, and patients was an important factor in the withdrawal of this bill just prior to a vote.
With the healthcare reform debate ongoing, providers will need to continue addressing current barriers to care-such as rising health insurance premiums and limited choice of providers-when planning transitions for our vulnerable patients and their families. Developing a healthcare reform proposal that is feasible and patient-centric and provides for efficient, quality healthcare remains an enormous bipartisan challenge and one for which a comprehensive solution is not currently in sight.
NANN recognizes that while the healthcare debate is ongoing, it impacts not only healthcare but also our lives and our profession. NANN members and other providers are encouraged to reach out to their state and federal representatives to help these legislators better understand provider challenges, as well as the barriers our patients and their families face in seeking healthcare. Your professional voice is important as our congressional representatives move forward on approving the fiscal year 2018 budget and as they seek to develop a commonsense proposal for healthcare reform.