Emily J. Holubowich, Senior Vice President at CRD Associates, is NAPHSIS's Washington representative and leads our advocacy efforts in the nation's capital.
On November 6th, Americans elected Donald J. Trump to be the 45th President of the United States, and in January he and Congress will begin working on their priorities, unhindered by a split government. The change in leadership will alter the landscape for investments in vital records data. However, as budget cuts loom, new initiatives of the forthcoming Administration may leave room for completing the modernization of electronic death reporting systems in states that have yet to adopt the technology.
The first clear impact of the election results will be in the decision on how to fund the government through the end of fiscal year (FY) 2017. Current funding for the government is scheduled to run out on December 9th, meaning that the 114th Congress will have to pass some legislation to keep the government running. However, with the overall win in the election, Republicans are pushing for a continuing resolution, or "CR", through March that will allow them to make final spending decisions for the year after President-elect Trump is sworn into office. Should they be successful, programs that affect NAPHSIS members, such as the National Center for Health Statistics, will be funded at current levels through March.
After March, the future of federal funding for nondefense discretionary (NDD) programs, which include all of the core functions that government provides for the benefit of all, such as NCHS, remains uncertain. While there is generally bipartisan support for NCHS and vital records systems, the bigger budget debate threatens the availability of funds for appropriators to use to support this wide range of activities. Already, the caps on NDD have put pressure on otherwise popular bipartisan programs. However, it is possible that the cap in NDD gets even tighter as some Members of Congress have proposed increasing the caps on defense spending and paying for the increases with further cuts to NDD. So, while the Center is not on the forefront for cuts, it could see a reduction in its annual appropriation due simply to the unavailability of funds.
Following 2017, funds will continue to be capped through FY 2021. Though, the caps will continue to be uncertain as the Bipartisan Budget Act of 2015 runs out and caps return to sequestration levels. In the past, Congress has provided relief from these austere levels, but with the new leadership in Washington, it appears unlikely that additional funding will be restored for NDD programs. Rather, it is possible that Congress will act to further reduce this pool of funding through offsets for additional defense funding or as part of a deficit reduction strategy, such as the Trump Penny Plan.
In spite of the tightening NDD budget, there could be new opportunities to expand and improve upon electronic vital records systems. One of the most talked about plans of the President-elect is his plan to invest in infrastructure during his first 100 days in office. While much of the plan will focus on roads, bridges, and air traffic control, President-elect Trump has also left his vision for infrastructure open to "pressing domestic infrastructure needs." NAPHSIS believes that bringing birth and death records into the 21st Century is critical to our public health infrastructure and therefore a pressing domestic need. We will continue to monitor for opportunities to update vital records systems as part of any infrastructure plan put forth, as well as continue to advocate for funding for the National Center for Health Statistics.