Automatic cuts to health care spending as part of the sequester will become effective on March 1, 2013, if Congress does not find an alternative way to reduce the budget deficit. If Congress cannot come up with an alternative, it will impose upon itself on Friday an $85 billion budget reduction, resulting from across-the board cuts. Health care will be one of the areas hardest hit, according to the White House.
Mental Health Cuts
One of the most serious cuts will come in areas affecting mental health. According to the White House, if the sequestration takes effect, up to 373,000 seriously mentally ill adults and seriously emotionally disturbed children could go untreated, which would likely lead to increased hospitalizations. This would be a result from direct cuts to the Mental Health Block Grant program which provides mental health services for seriously mentally ill adults and seriously emotionally disturbed children not receiving needed mental health services. Additionally, close to 8,900 homeless persons with serious mental illness would not have the outreach, treatment, housing, and support they currently receive through the Projects for Assistance in Transition from Homelessness (PATH) program.
AIDS and HIV Treatment and Prevention
The White House has indicated that cuts to the AIDS Drug Assistance Program could potentially result in 7,400 fewer patients having access to life saving HIV medications. Further, approximately 424,000 fewer HIV tests could be conducted by Centers for Disease Control (CDC) state grantees, which could result in increased future HIV transmissions, deaths from HIV, and costs in health care.
Cuts in funding to the Indian Health Service and Tribal hospitals and clinics could reduce their ability to provide services. With the cuts, these facilities would be forced to provide 3,000 fewer inpatient admissions and 804,000 fewer outpatient visits.
The White House has posted several state-specific examples of the ways the cuts will hurt areas such as public health. For example, Illinois public health programs will lose approximately $5 million for programs dealing with public health threats, substance abuse treatment and prevention, HIV testing and childhood vaccinations. California and Texas will rank among the hardest hit states, with funding decreases of over $18 million and $10 million, respectively. The Washington Post has also created a table showing the significant spending cuts across the board, state by state and each category of cuts from the sequester.
Impact on Public Health
Health-specific programs are not the only place being cut that will have an effect on public health. For example, the Federal Emergency Management Agency would likely have deep cutbacks, reducing funding for state and local grants that emergency management personnel, which would hamper the federal government’s ability to respond to natural disasters like Hurricane Sandy and other emergencies. The Food and Drug Administration’s Center for Drug Evaluation and Research would also experience cuts. Approximately 600,000 women and children would be dropped from the Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) from March through September. These cuts and others like them are likely to have a significant downstream impact on public health.