The Trump administration released a “blueprint” of its proposed budget cuts for 2018 that would deliver a blow to the Department of Health and Human Services (HHS), trimming nearly 18 percent from its budget.

The administration said the cuts to the HHS, along with those to the Environmental Protection Agency, the Department of Agriculture and other branches of the government, are necessary to offset the proposed $54 billion increase in defense spending.

 Here are the details:

  • The National Institutes of Health (NIH), which provides grants to universities, teaching hospitals and other institutions for biomedical research, would be particularly hard hit, losing $5.8 billion. NIH grants created more than 313,000 jobs in fiscal year 2009, according to a study published in December 2015. A “major reorganization” of the NIH under the proposed budget plan would eliminate the Fogerty International Center, which focuses on global health research.

  • Funding for the Centers for Disease Control and Prevention would be “reformed” under the plan, though it isn’t clear what that means. A $500 million block grant for state public health agencies is mentioned, as is the creation of a Federal Emergency Response Fund, but the details for both are sketchy.

  • The proposed outline also calls for the termination of programs within the Office of Community Services that help low-income families, which the administration says would save $4.2 billion, but funding for community health centers and safety net providers would continue. There’s also a $403 million reduction in funding for dedicated programs to train nurses and other health care professionals.

  • Drug and medical device companies applying for FDA approval would pay roughly twice as much in user fees, which, though not explicitly stated in the plan, might be used to help fund implementation of the 21st Century Cures Act passed last year.

  • The Health Care Fraud and Abuse Control Program would receive $70 million in additional funding, and the Substance Abuse and Mental Health Services Administration would receive $500 million to “expand opioid misuse prevention efforts” and increase access to treatment for those who are addicted.

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