AAMC Statement on President’s FY 2019 Budget Proposal

AAMC (Association of American Medical Colleges) President and CEO Darrell G. Kirch, MD, issued the following statement in response to President Trump’s FY 2019 budget request, which addresses graduate medical education (GME) and workforce funding, the National Institutes of Health (NIH), the 340B Drug Pricing Program, Medicaid and Medicare, and the Public Service Loan Forgiveness (PSLF) program:

“The administration’s proposed cuts would be devastating to patients, current and future providers, the health care safety net, and, ultimately, our nation’s health security.

As the nation experiences a shortage of up to 104,900 physicians by 2030, in both primary and specialty care, the president’s proposed $48 billion cut to graduate medical education payments would undermine federal support that already does not adequately reimburse the costs associated with training future providers. The president’s proposal would exacerbate the projected physician shortage by forcing teaching hospitals to absorb untenable cuts and make difficult choices between training more physicians for the future needs of the nation and maintaining life-saving clinical services for their communities.

The AAMC also is disturbed that the administration proposes to eliminate Title VII health professions programs, Title VIII nursing workforce development programs, and the Public Service Loan Forgiveness program, which are designed to improve the supply, distribution, and diversity of the health professions workforce. These programs have been consistently effective in recruiting and training health care professionals who are able to adapt to the changing needs of underserved communities and the nation’s growing, aging population.

We appreciate the administration’s stated goal to combat high drug prices—there is no question that prescription drugs have become unaffordable for many Americans. However, the proposal regarding the 340B Drug Pricing Program does nothing to address this problem and is counter to the intent of the program. At no cost to taxpayers, the 340B program provides vulnerable patients and their communities with access to life-saving services, including free or discounted prescription drugs. Unless and until drug prices are addressed directly, any plan to address rising drug prices should expand—not weaken—this critical program.

We also are concerned about proposals to block grant Medicaid, to cut facility-based reimbursements to all hospital-based outpatient departments, and to reduce support for uncompensated care by $70 billion. These proposals would not only dismantle the safety net, but also would disrupt care for all patients.

Finally, while we appreciate that the administration proposes to increase research within the Department of Veterans Affairs and invest in efforts to address the opioid epidemic, the budget request undervalues the vital role of sustainable, meaningful growth in base funding for the National Institutes of Health. At its core, the budget proposal would maintain funding at the FY 2017 level. Medical research is bringing us closer to cures for patients suffering from cancer, diabetes, Alzheimer’s, and other chronic and life-threatening diseases. This proposal does not keep pace with the budget trajectory Congress has laid out to advance discovery, strengthen local and regional economies, and maintain America’s standing as the leader in innovation and health care.

The AAMC and the nation’s medical schools and teaching hospitals urge Congress to reject the proposals harmful to programs that are vital to the health of the nation.”


The Association of American Medical Colleges is a not-for-profit association dedicated to transforming health care through innovative medical education, cutting-edge patient care, and groundbreaking medical research. Its members are all 152 accredited U.S. and 17 accredited Canadian medical schools; nearly 400 major teaching hospitals and health systems, including 51 Department of Veterans Affairs medical centers; and more than 80 academic societies. Through these institutions and organizations, the AAMC serves the leaders of America’s medical schools and teaching hospitals and their more than 173,000 full-time faculty members, 89,000 medical students, 129,000 resident physicians, and more than 60,000 graduate students and postdoctoral researchers in the biomedical sciences.