The Department of Health & Human Services would see an 18% funding cut under the first budget proposal from the Trump administration.

The proposal , submitted to Congress March 16, would cut $15.1 billion from fiscal 2017 levels, funding the agency at $69 billion for fiscal year 2018. More than a third of the cuts come from the National Institutes of Health.

The NIH’s overall budget would drop to $25.9 billion in FY 2018, down $5.8 billion from this year (fiscal 2017). The proposal includes “a major reorganization of NIH’s institutes and centers to help focus resources on the highest priority research and training activities, including: eliminating the Fogarty International Center , consolidating the Agency for Healthcare Research and Quality within the NIH, and other consolidations and structural changes across NIH organizations and activities,” according to summary documents from the Office of Management and Budget.

The proposed cuts also account for the funds that are to be appropriated for the 21st Century Cures Act , which was supposed to add $4.8 billion in new appropriated funding, including funds dedicated to the Cancer Moonshot and the BRAIN Initiative .

The Centers for Disease Control and Prevention also would be reformed, getting a new $500 million block grant “to increase state flexibility and focus on the leading public health challenges specific to each state.” It also creates a new Federal Emergency Response Fund to respond to public health outbreaks such as the Zika virus.

The White House proposal earmarks a $500 million increase above 2016 levels “to expand opioid misuse prevention efforts and to increase access to treatment and recovery services to help Americans who are misusing opioids get the help they need.”

Another area receiving a boost under the proposal is the funding for the Health Care Fraud and Abuse Control program at the CMS, which would receive $751 million in fiscal 2018, about 10% more than it did in fiscal 2017. The budget document notes that the “return on investment for the HCFAC account was $5 returned for every $1 expended from 2014-2016.”

Other cuts highlighted by the proposal include elimination of $403 million in health professions and nursing training programs, “which lack evidence that they significantly improve the nation’s health workforce,” and a $4.2 billion cut from the elimination of discretionary programs within the Office of Community Services.

gtwachtman@frontlinemedcom.com

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