Dr. Leana Wen: President Trump’s Proposed Federal Budget Harms the Health of Baltimoreans

The federal budget proposal released on Tuesday by President Trump cuts life-saving services and will harm the health and well-being of hundreds of thousands of Baltimoreans. It will particularly affect the following individuals:



Seniors: One hundred thousand Baltimore City residents are over the age of 60, and 1 in 6 of these residents live below the poverty line. Cuts to Medicaid—which covers services that Medicare does not—could leave these seniors without prescription drugs, glasses, and hearing aids. The budget also makes cuts to essential programs like nursing home care and Meals on Wheels, which provides more than 187,000 meals to Baltimore older adults in their homes in each year.



Children: Eighty thousand children in Baltimore depend on Medicaid and the Children’s Health Insurance Program (CHIP) for medical care. By cutting Medicaid, removing the enhanced federal match rate for CHIP, and capping reimbursement for CHIP services, the proposed budget will limit the ability of children to get basic health services such as immunizations and treatment for asthma.



Individuals with substance use and mental health disorders: Even though the administration is touting increases in spending to treat opioid use disorders, the proposed budget slashes funding for substance abuse prevention efforts and the Community Mental Health Services Block Grants, a cut that targets the 70,000 Baltimore residents who receive publicly-funded services for substance use disorders and mental health needs. Cuts to Medicaid would affect the 1 in 3 Marylanders who depend on Medicaid for treatment of addiction. Those who depend on private insurance could also lose coverage, because the repeal of the Affordable Care Act could result in the removal of treatment for substance use and mental health disorders as essential health benefits. At a time of a public health emergency around opioids, with unprecedented numbers of Marylanders dying from overdose, this proposal could deprive millions of the care that they need.



People with chronic diseases, including heart disease, diabetes, and cancer: In Baltimore and around the country, these are among the leading causes of death. Yet, one of the largest line-item cuts proposed for the Centers for Disease Control and Prevention (CDC) affects spending on precisely these areas. There are also $186 million in cuts to treatment for HIV/AIDS and other infectious illnesses, potentially affecting care for the 13,000 Baltimoreans living with HIV. This is especially troubling considering that the proposal to repeal the Affordable Care Act will further limit protections for these individuals, pricing tens of thousands of Baltimoreans with these preexisting conditions out of the ability to obtain health insurance.



Baltimoreans who are the most vulnerable: By cutting Medicaid spending by nearly half over 10 years, the proposed federal budget would reduce access to health insurance for the approximately 200,000 Baltimore residents who rely on Medicaid. This includes half of our city’s 9,000 pregnant women every year, who may be forced to forgo prenatal care. Studies show that women who do not receive prenatal care are five times more likely to have babies who die than women who do get care. The budget also reduces funding for the Supplemental Nutrition Assistant Program—which helps feed low-income children in nearly 54,000 Baltimore households—by 28.8 percent and for Temporary Assistance for Needy Families by 13.1 percent, tearing up the safety net that protects single mothers and their children.

The proposed federal cuts will have devastating consequences for Baltimoreans, resulting in worse health that will affect generations of our residents. This proposed budget is fiscally irresponsible and puts all Americans at risk.

Dr. Leana Wen is the Baltimore City Health Commissioner. Twitter: @DrLeanaWen and @BMore_Healthy.