On Tuesday the Trump Administration issued its FY2018 budget proposal that would slash programs covering low-income adults and children, as well as programs funding medical research.

The budget would cut Medicaid funding by $610 billion over 10 years, on top of the Medicaid cuts included in the original House version of the American Health Care Act (AHCA).  While President Trump’s proposal would extend the Children’s Health Insurance Program (CHIP) by two years, through FY2019, the proposed budget eliminates increased federal matching funds to CHIP from the Affordable Care Act, thereby cutting CHIP funding by $5.8 billion.

While drastic cuts to the National Institutes of Health (NIH) were hinted at in a brief budget outline the administration released earlier this year, the actual proposed cut of $5.7 billion contained in Tuesday’s budget proposal still managed to shock those in the medical community. The Trump NIH cuts include $1 billion in reductions to the National Cancer Institute, $838 million in cuts to the National Institute of Allergy and Infectious Diseases, and $355 million in cuts to the National Institute of Diabetes & Digestive and Kidney Diseases.

“Compassion needs to be on both sides of the equation,” said Office of Management and Budget director Mick Mulvaney, explaining that the needs of people receiving benefits through government programs must be balanced against those paying taxes to fund the programs.

In an appearance on the WGBH-TV program “Greater Boston,” with the  Boston Globe’s  Dante Ramos and former State Treasurer Joe Malone, MHA President & CEO Lynn Nicholas, FACHE, noted that 25% of Massachusetts residents are eligible for Medicaid, including approximately half of the children in the state. As for the NIH cuts, Nicholas said, “We are built on research and innovation that powers part of Massachusetts and the excellence of healthcare here.” She added that Massachusetts receives the second highest total of NIH funding in the U.S. (behind California) and that Massachusetts General Hospital receives more NIH funding than any other single U.S. hospital.

Democrats slammed the budget proposal, but criticism also came from across the GOP. Presidential budgets never survive Congressional review; they are usually just a statement of the administration’s intents. Nicholas on “Greater Boston” concurred with the prevailing consensus that the president’s budget proposal was most likely dead in the water.

“This budget is like a giant, humungous tweet,” she said to chuckles from the panel, “and most of [ the president’s ] tweets have proven not to be realistic.”