The Coronavirus has quickly moved from an epidemic to a global pandemic, with 13 confirmed cases in the United States already and more feared to be on the horizon. As we scramble to contain Coronavirus and similar diseases in the future, it will become clear that cuts made over the last three years by the Trump administration and proposed reductions in health care funding will seriously hamper basic efforts to battle public health emergencies.
While Trump and the Republican Party’s several attempts to overturn the Affordable Care Act (ACA) failed, several administrative actions and executive orders have severely weakened some of its most important provisions.
For starters, the rate of uninsured Americans has surged to the highest level since the ACA took effect – 14 percent of Americans don’t have health insurance, up from 10.9 percent in 2016. In other words, over 7 million Americans have lost health coverage since Trump took office.
People without health insurance are significantly more likely to delay care, simply because out-of-pocket costs are outrageous in our largely privatized health care system. During a rapidly growing public health emergency like Coronavirus, delays in seeking and receiving care will inevitably result in increasing person-to-person infections and cause unnecessary deaths.
Additionally, last year Trump shut down a federal program called Predict that was established ten years ago as a response to the H5N1 bird flu outbreaks. Predict investigated and provided surveillance of infectious diseases and viruses, studied and discovered new diseases that are able to jump from animals to humans, developed testing to detect these viruses, and trained “medical detectives” on the ground across the globe. This federal ability to avert pandemics is now mostly gone, making our ability to contain diseases worldwide significantly more difficult.
Recently, the Health Resources and Services Administration (HRSA) announced that it needed significantly more money than the $105 million allocated by Congress, in order to support public health efforts beyond the travel bans and quarantine rules that have been the Trump administration’s tepid response to date.
In 2018, federal public health workers had their paychecks slashed because of alleged “government delays” in setting up a payment system Congress had ordered and allocated money for years ago. Following the pay cuts — which were eventually restored, but still caused significantly and understandably decreased morale in the service corps — Trump announced that he would be cutting nearly 40 percent of the uniformed federal public health professionals who are deployed to disease outbreaks, natural disasters and humanitarian crises.
A beleaguered, demoralized and reduced U.S. Public Health Service Commissioned Corps will cripple our ability to respond to Coronavirus and other diseases like it. Overall, Trump is proposing to cut the doctors, nurses, engineers and public health professionals working for the federal government from 6,500 officers to “no more than 4,000 officers.”
Further still, the Trump administration’s “Regulatory Reform Results for Fiscal Year 2019” made dramatic cuts to federal regulatory and administrative functions. On the ground, this means things like: cuts to child and family nutrition programs that will make children less healthy and therefore more vulnerable to disease, as their immune systems are weakened by a lack of nutrition; and a reduction of standards for growing, harvesting, packing and holding of produce for human consumption, which will make our food supply more susceptible to contaminants that can make us sick.
Trump is also proposing drastic cuts this year to the Centers for Disease Control and the National Institutes of Health — key federal agencies that research and respond to public health emergencies — including a $838 million cut to the National Institute of Allergy and Infectious Diseases. A proposed $2.6 billion cut to the Environmental Protection Agency would eliminate crucial programs that address climate change, which would be detrimental to public health as rapidly warming environments create petri dishes for the spread of viruses, and would also cut programs that monitor and restore water quality.
These cuts are unacceptable in the face of a growing global public health emergency.
It’s no wonder the Health and Services Resources Administration is in a panic and scrambling to develop an adequate response to the growing Coronavirus health emergency. A constant barrage of cuts, deterioration, weakening and outright elimination of America’s historically robust public health infrastructure has made us vulnerable.
While Coronavirus is our current concern, we should always be prepared to deal with public health concerns. As a wealthy country with plenty of resources, the United States has a unique responsibility to work to research, predict, contain, and treat diseases. The Trump administration’s insistence on cutting programs that keep us healthy not only put people living in the United States at risk — it makes the world more dangerous for everyone.
The Trump administration should immediately reverse cuts to critical federal agencies in order to protect public health worldwide, and Congress should allocate more funds to combatting the current virus of concern. Finally, we must work towards guaranteeing affordable, comprehensive health care to everyone living in this country, in order to ensure people can access the preventative and emergency care we need to protect against public health scares in the future.
Jim Mangia is CEO and president of St. John’s Well Child and Family Center.