As the new administration gets settled and sets its priorities, President Donald Trump and Congress presumably will be assessing how taxpayer dollars can be best utilized.
In the coming month, Trump will begin to not only introduce a budget for the upcoming fiscal year but also push for specific initiatives that will require some level of funding to accomplish.
The U.S. has a number of issues that require an intense look. Health care and job creation are among those at the top of the list. However, with a budget of more than $3 trillion, there is room for spending that will have broad impact and that will support cross-cutting initiatives.
Though in its infancy, the Trump administration already has put forward border security as a priority, which is in line with one of his major campaign promises. Cost estimates for one aspect of this effort have ranged anywhere from as low as $5 billion to $10 billion to as much as $25 billion. Congress, however, has indicated that it will consider funding only up to $15 billion of the projected cost.
With funding at this level being discussed, it’s only natural to imagine the impact of that funding if it were to be invested differently. More specifically, we’ve been thinking about how these funds could benefit the research community and public health.
While a huge influx of funding would be welcome, predictable and sustainable increases are better for the research community in the long run.
What remains to be seen or discussed is where the $15 billion will come from. Trump’s preferred source of funding for his campaign promise already has denounced the idea, leaving taxpayers to cover the bill. Since passage of the Budget Control Act in 2011, Congress has required “pay fors” that provide funding for increases in spending. To put it another way, in order to increase spending, you must identify where in the federal budget dollars can be taken from.
House Speaker Paul Ryan, R-Wisc., uncharacteristically quickly committed to fund the initiative, though recent history would have led people to predict the contrary. Last year, when the Zika virus was spreading into the U.S., President Barack Obama implored Congress to provide just $1.9 billion to combat the disease. Congress, however, was unable to agree on where the funding would come from, what the funding levels would be and bill riders, ultimately delaying the emergency funds for eight months. Even then, once finally passed, Congress provided less than the president’s request.
The bipartisan 21st Century Cures Bill was debated for more than 18 months. Once it was signed into law, funding for the National Institutes of Health was reduced from the initial $9 billion increase over 10 years to a more conservative $4.5 billion, because Congress was unable to identify sources for more funding.
Hopefully, in light of the 115th Congress’ renewed vigor, we will see it move more quickly on funding for public health emergencies and national initiatives than it did during eight years of obstruction and without the inclusion of poison pills in legislation.
Every president pushes forward his own agenda, for better or worse. We hope that, under Trump, programs that support education, health and basic research will be liberated from the fiscal scythe of Congress.