Dear IHP community,

As I read the news report on the President’s budget request released on March 11, I became interested in how the $7 billion cut in the Department of Education budget would affect the IHP community and our students. I am worried about the borrowing capacity of our students as well as their ability to rely on the Public Service Loan Forgiveness Program. Then I realized that the IHP community is directly affected by the budgetary proposal in two important areas: education and health care.

I thought it might be helpful to summarize the proposed changes in President Trump’s budget. We all have a responsibility to be knowledgeable about the proposed changes and work as individuals to make sure that our elected representatives know how we feel about the changes. The IHP will be voicing our concern over proposed changes to student aid and the student loan process as well as other areas of the President’s budget that negatively affect higher education and access to and delivery of health care. 

Highlights of the proposed changes affecting higher education include:

  • Several of the undergraduate grant programs such as Pell and SEOG will either be cut or eliminated. 
  • The Federal TRIO Programs (TRIO) which is a student services programs designed to identify and provide services for individuals from disadvantaged backgrounds will be cut by $110 million on a $950 million budget.
  • There will be the elimination of the Public Service Loan Forgiveness Program.
  • In addition, there is a proposal to streamline in the Income Driven Repayment Program (IDR) – increasing the forgiveness period to 30 years for graduate students.

Highlights of the proposed changes affecting health care include:

  • Nearly $1.5 trillion would be cut from Medicaid over 10 years. The budget also ends funding for Medicaid expansion, the program that allows the working poor to be able to get Medicaid services among other benefits.
  • Medicare spending would be reduced by $800 billion over 10 years. 
  • There would be a cut of $900 million from the National Cancer Institute’s budget and an additional $1 billion from the NIH for medical research.
  • On the positive side, an additional $292 million would go to curb the spread of HIV with a portion of that going to the CDC to improve diagnosis and testing for HIV in areas where infected people are not getting proper treatment.

From all that I have read, it is unlikely that this proposed budget will pass a divided Congress, but it does let us know what the President thinks is a priority. By April 15, Congress will pass its budget resolution to guide decision-making for 12 appropriation subcommittees, which begin hearings on specific proposals. This process could last into the summer.

As President of the IHP, I am concerned about the provisions in the budget that could affect our students such as those that reduce access to loan dollars and making the loan dollars that are available harder to obtain. I worry about the recommendation to eliminate the Public Service Loan Forgiveness Program, a program many of students benefit from.

I also worry about our society. As we enter a time when our population is aging, and there is a significant physician shortage, and our societal challenges require the kind of attention provided by health care providers, we can’t afford to prepare fewer providers...we need more. Anything that will constrict the pipeline that prepares health care providers is counter to our preferred future as a country.   

As health care providers, we have a responsibility to advocate for our patients not only in the clinical setting but in the policy arena. Reducing access and limiting coverage for individuals who are already experiencing the challenges of poverty, illness, and disability will only serve to further erode the fabric of our families and communities in most need. Our voice must be heard on behalf of those individuals we care for, who have not yet found their voice. 

I encourage you to read the proposed budget and make up you own mind on where you stand on the issues. We are a community that values all kinds of diversity including diversity of thought. Whatever you decide, make your voice heard. Make sure your legislator knows how you feel. Continue to be part of the solution by seeking ways to improve access and care. Being a health care provider requires us to shape the health care delivery system for the benefit of our patients. Let’s make sure we all raise our voices on these important issues.