WASHINGTON – U.S. Senator Chris Murphy (D-Conn.), a member of the U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee, joined U.S. Senator Patty Murray (D-Wash.), Ranking Member of the HELP Committee, and 9 other senators in calling on President Trump to drop his attempts to implement the 18 percent reduction laid out in his proposed budget, as well as his efforts to cut the federal civilian workforce at the Department of Health and Human Services (HHS). In a letter to President Trump, the senators say these proposed cuts jeopardize critical efforts to implement the bipartisan 21st Century Cures Act, which includes Murphy’s Mental Health Reform Act to expand federal resources and improve coordination for mental health programs, commits real dollars to the fight against the opioid epidemic, and ensures that investments in research will benefit all Americans – including women, children, LGBTQ individuals, and people of color.

“Republicans and Democrats came together to make key investments in biomedical research, mental health care, health information technology, and innovation, and members on both sides of the aisle have rejected your proposed cuts to these and other priorities at HHS,” wrote the senators. “We urge you to listen to both sides of the aisle and drop any attempts to implement the damaging proposed cuts at HHS laid out in your budget.”

In the letter, the senators highlight several provisions of the law where the proposed cuts would significantly harm efforts to help patients and families—from advancing biomedical research for lifesaving cures and treatments, to expanding access to mental health care, using health information technology to help patients and providers, and equipping FDA with tools to review innovative treatments.

“Your proposed budget and workforce cuts would take us in the opposite direction and leave those patients and families waiting even longer than they already have,” the senators concluded. “We urge you to instead prioritize the work of these critical agencies.”

Murphy introduced his Mental Health Reform Act after holding more than a dozen roundtable across Connecticut with mental health consumers and providers. The new law expanded federal resources and improved coordination for mental health and substance abuse treatment programs. 

In addition to Murphy and Murray, the letter was signed by U.S. Senators Tammy Baldwin (D-Wis.), Bob Casey (D-Pa.), Richard Durbin (D-Ill.), Al Franken (D-Minn.), Maggie Hassan (D-N.H.), Jack Reed (D-R.I.), Brian Schatz (D-Hawaii), Jeanne Shaheen (D-N.H.), and Sheldon Whitehouse (D-RI).

Full text of the letter is below and available online HERE.

May 16, 2017 

The Honorable Donald Trump
President
The White House
1600 Pennsylvania Avenue  
Washington, DC 20500

Dear President Trump, 

We write with extreme concern about the impact your proposed budget cuts and workforce reductions for the Department of Health and Human Services (HHS) would have on the implementation of the bipartisan 21st Century Cures Act, passed into law last year. Republicans and Democrats came together to make key investments in biomedical research, mental health care, health information technology, and innovation, and members on both sides of the aisle have rejected your proposed cuts to these and other priorities at HHS. We urge you to listen to both sides of the aisle and drop any attempts to implement the damaging proposed cuts at HHS laid out in your budget. 

The 21st Century Cures Act invests in tackling our hardest-to-treat diseases, commits real dollars to the fight against the opioid epidemic, makes badly-needed changes to mental health care, and ensures that investments in research will benefit all Americans, including women, children, LGBTQ individuals, and people of color.  The law charges agencies across HHS with accomplishing these goals.  Your proposed 18 percent reduction in funding for HHS and cuts to the federal civilian workforce jeopardizes these critical efforts:

Advancing biomedical research for lifesaving cures and treatments: Right now, more than five million people in the United States live with Alzheimer’s disease, and, according to the National Cancer Institute, 39 percent of Americans will be diagnosed with some form of cancer in their lifetimes. These staggering statistics represent enormous hardship, suffering, and loss in nearly every family and community. The 21st Century Cures Act provides NIH with new, stronger, and sharper tools in the fight against these diseases -- to advance research, support investigators early in their careers working to make discoveries, and ensure more diverse clinical trial participation to improve our understanding of prevention and treatment. But in order to deploy these tools, NIH must have the resources to implement them. 

Expanding access to mental health care: According to a 2015 report by the Substance Abuse and Mental Health Services Administration (SAMHSA), within the past year about 43.4 million American adults had a mental illness, and about 20.8 million Americans had a substance use disorder. The 21st Century Cures Act tackles this challenge by establishing and updating programs that expand access to quality care for mental illness and substance use disorders. For example, the Act requires that SAMHSA provide resources to help patients to get in touch with specialized providers, for states to coordinate local agencies engaged in crisis intervention, to strengthen the mental health and substance use disorder workforce, and to improve integration of mental and physical health care. In order for these programs to be successful, SAMHSA needs adequate resources and support from HHS to begin making these important reforms to our mental health system.  

Using health information technology to help patients and providers: In 2015, the HELP Committee undertook a substantial review of health information technology (HIT), holding six hearings with experts, stakeholders, and members of the Administration. The Committee reviewed a range of issues, including information blocking, interoperability, patient access to electronic health information, and federal certification of HIT. Incorporating the findings from those hearings, the 21st Century Cures Act gave the Inspector General of the Department of Health and Human Services new authorities to investigate and penalize information blocking. It also requires the Office of the National Coordinator for HIT implement conditions of certification to reinforce the interoperability of certified HIT and establish an electronic health record reporting program to give hospitals and physicians more information about the interoperability, usability, and security of HIT.

These new policies will have far-reaching benefits; for example, usability impacts the ease with which health care providers can use an electronic health record system and protects against inadvertent patient harm. Other policies that modernize our health care system to bolster innovative care include ensuring health information technology software meets the unique needs of children and protecting children.  Errors like weight-based medication dosing within an electronic health records system can make children susceptible to incorrect medication and other health IT-related safety events. The Office of the National Coordinator and the Office of the Inspector General require adequate funding to accomplish the important objectives established in the 21st Century Cures Act, in addition to the critical work they already do to promote the use of interoperable HIT in improving health care quality and efficiency.

Equipping FDA with tools to review innovative treatments: The 21st Century Cures Act invests in helping the FDA meet high standards of patient and consumer safety in the face of expanding oversight and demand.  The law expands the FDA’s hiring authority to help the agency recruit the best and brightest scientific minds to review cutting-edge technologies. It established new inter-center institutes to break down traditional drug, device, and biologic silos, and enhances the patient voice in drug development. Congress authorized additional resources specifically for the agency to carry out this important work.

Despite these critical advancements, in your Budget Blueprint for FY 2018, you proposed significant cuts to several of the agencies key to implementation of the 21st Century Cures Act.  The proposed $69 billion in your budget proposal for HHS represents a cut of $15.1 billion or an 18-percent cut to the HHS budget.  The budget would also supplant the $1.06 billion allocated by the Act to HHS agencies for crucial bipartisan priorities, such as the Precision Medicine Initiative and state grants to combat the opioid epidemic.

In addition to proposing draconian budget cuts, the steps you have taken to freeze federal hiring and reorganize and reduce the federal workforce threaten to hamper implementation of the 21st Century Cures Act.  Your March 13, 2017 Executive Order directed the Office of Management and Budget (OMB) to submit a comprehensive plan to reorganize Executive Branch departments and agencies, and a subsequent OMB memo directed each agency to compile an “Agency Reform Plan” by June 30 and to take near-term workforce reduction actions.  These actions may disrupt or eliminate programs critical to implementation of the law and run contrary to congressional intent to expand and strengthen the workforce at FDA.  Furthermore, efforts to reduce or reorganize the federal workforce will undoubtedly create unnecessary hurdles to successful implementation of other provisions of the 21st Century Cures Act.

The United States has a history of life-saving, world-changing medical innovation. From eradicating smallpox to mapping the human genome—our country has found ways to combat seemingly unbeatable diseases and public health threats.  Republicans and Democrats have come together to invest in advancing innovative medical research for patients and families who are waiting and hoping for new cures and treatments. Your proposed budget and workforce cuts would take us in the opposite direction and leave those patients and families waiting even longer than they already have. We urge you to instead prioritize the work of these critical agencies.  

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