In his first address to a joint session of Congress, President Donald Trump promised “heroic veterans will get the care they so desperately need,” that he would eliminate the defense sequester, and called for “one of the largest increases in national defense spending in American history.”
“This looks like an increase in resources for us,” VA Secretary David Shulkin, MD, is reported to have told reporters early in the day at an American Legion meeting. “I'm confident this budget is going to reflect the President’s commitment to his ability to deliver on his promises to make veterans care better and stronger.” According to reports, the White House already has approved 37,000 exemptions from the federal hiring ban to help fill the VA’s 45,000 current job vacancies.
Reports also suggest that the military will receive an additional $54 billion in funding, a 10% increase. Details of where that extra money will go have not been released. The President’s military budget is less than the $640 billion budget proposed by Senator John McCain (R- AZ) and represents a 3% increase over the budget that had been projected by President Obama.
The overall impact on federal health care remains unclear. While President Trump held to his promise to repeal and replace the Affordable Care Act, to “invest in women’s health,” and to “give our state governors the resources and flexibility they need with Medicaid to make sure no one is left out,” there were few details of how those promises would be implemented and where the funding will come from.
In the address, the President outlined 4 necessary elements of an Affordable Care Act replacement:
- Americans with pre-existing conditions would have access to coverage, and a stable transition for health care exchanges enrollees;
- The use of tax credits and savings accounts for purchasing private insurance;
- Flexibility for states to expand Medicaid coverage; and
- Legal reforms that “protect patients and doctors from unnecessary costs that drive up the price of insurance and work to bring down the artificially high price of drugs and bring them down immediately.”
The FDA also drew the President’s attention. Calling the approval process “slow and burdensome,” the President charged that the FDA “keeps too many advances… from reaching those in need.” The agency is still waiting on a nomination for its commissioner position, and it is unclear how it can speed up approval while under the federal hiring freeze.
Recognizing the devastation of opioid addiction, the President also promised to “stop the drugs from pouring into our country and poisoning our youth, and we will expand treatment for those who have become so badly addicted.” The President did not specify whether treatment resources would be exempt from the hiring freeze, incorporated into the Affordable Care Act, or handled in a different manner.