Trump cuts affect Guam

Trump cuts to affect Guam

The full potential impact of President Trump’s proposed federal spending cuts isn’t clear yet, but early estimates show Guam’s federally funded safety-net programs for people who can’t pay for their own health care or food would suffer if the plan becomes law.

The Department of Public Health and Social Services prepared initial projections based on a 10 to 30 percent reduction scenario stemming from Trump’s budget cut proposals for next fiscal year.

“If Mr. Trump’s budget were to pass unscathed, we would be devastated,” said Director James Gillan of the Department of Public Health and Social Services.

Trump’s budget proposal requests a 10 percent increase in military spending next fiscal year alone, by $54 billion, but proposes cuts to Public Health services, education and other vital services.

Based on Public Health’s projection, at a 30 percent budget cut for various programs, the department would have to suspend hiring or let go of certain employees paid for with federal funds. The total number of impacted jobs isn’t known, but several jobs in each of the department’s federally funded programs could be in jeopardy, according to the department’s initial review.

Services such as lab testing, immunizations, and prevention of tuberculosis and mosquito-borne illnesses would have to be reduced or canceled as well, according to the department’s projections.

Some of Public Health’s estimated cuts, based on a 30 percent reduction, include:

• $12 million, from Medicaid;

• $4.2 million from the Medically Indigent Program;

• $2.4 million from the Temporary Assistance for Needy Families; and

• $1.2 million in administrative costs alone, not including the benefits that households receive under the Supplemental Nutrition and Assistance Program office costs.

The president is expected to propose cutting as much as 25 percent of funding for SNAP, commonly called the food stamps program, over 10 years, The Washington Post reported.

Nearly a third of Guam’s residents are on food stamps – 55,983 last fiscal year, but the amount has decreased from $113 million in fiscal 2014 to $106.8 million last year, Public Health has previously stated.

Gillan also showed a detailed analysis by the Association of State and Territorial Health Officials that lists nearly three pages of affected programs addressing respiratory diseases, birth defects and developmental disabilities, among other services.

Titled “A New Foundation for American Greatness,” Trump’s budget proposal would cut Medicaid funding by more than $12 million, reducing the approved fiscal 2018 funds for the program from $40.6 million to just $28.4 million.

At that rate, it’s projected that Guam medical providers’ participation from the program would decline. This was an issue raised during the department’s legislative budget hearing earlier this month.

Budgeting cautiously

The Trump budget cuts proposal should prompt GovGuam to be cautious with planning for how to spend money next financial year, which starts in October, said Speaker Benjamin Cruz.

“At this point, we have literally no idea how much support the Trump budget proposal has in either the House or the Senate,” Cruz said. “With so much uncertainty at play, GovGuam must act cautiously throughout the fiscal year 2018 budget process.”

Guam Delegate Madeleine Bordallo’s office yesterday said Trump also proposes to cut $3 million from annual Compact-impact funding, which helps Guam pay for services to immigrants from the Federated States of Micronesia, Palau and the Marshall Islands.

“President Trump’s budget proposal makes his administration’s priorities clear and will significantly harm the middle class and those who most need help,” she said.

Gillan hasn’t lost hope.

“I am hopeful that Gov. (Eddie) Calvo’s solid relationship with the president will help leverage help for the territories,” Gillan said.


Addressing the hospital crisis

Image result for guam memorial hospital

By Juan Flores

What if … our community insisted on and ensured that all residents receive 21st-century essential health care from our public hospital and Public Health clinics?

How can the governor, the senators and even the courts work on prioritizing resources so the compromises at the health facilities don’t lead to losing lives? What assurances can we get from our leaders that the “right to life” will be honored in determining how resources will be allocated, especially the time and energy it will take to address financial and procurement challenges?

We need to hear that someone is losing sleep over the issues at the Guam Memorial Hospital. We know that revenues from insurance companies, Medicare/Medicaid and direct payments are not meeting the demands for equipment, supplies and professional services that will have an impact on providing the right amount of care. If that continues to be true, what should be done? One approach is to run to the Legislature to secure more funding. That does not seem to be effective when allocations for tax dollars always lead to facing insufficient funds for “what we need” versus “what we would like to have.” Adequate health care is clearly a “need” rather than a “want.”

What other avenues can be taken to identify adequate funding, prioritize expenditures and provide the critical services, considering the expectations of the professionals at the hospital? How are the greatest financial, legal and health professional minds being brought to a table to map out an effective plan? We may all have faith that this is already taking place, but we’re not hearing about it. If any one of us finds ourselves or our loved ones at the hospital, will we be convinced that we will get the best possible care and ensure the likelihood we will be able to leave the hospital a little better than when we entered? We seem to be assured of the best care from the nurses, doctors and other staff members. We just keep hearing from them that they don’t always have the tools and supplies to do their best.

Our island community seems to face crises well when we put our hearts and minds to it. That has been true in the aftermath of natural disasters or impending events like FestPac. What’s happening at the hospital is a crisis. We will have confidence in what our leaders are doing if we know there is a viable plan. We also need to know that elements of the plan are being followed and that incremental successes have been achieved. We need to know that the sacrifices in some areas in our community are worth recognizing and living with for the sake of supporting the efforts for adequate health care at the hospital. As we have done in the past, we have to rally members of the community to stand behind our leaders, however they are to be identified and recognized, and make a hospital worthy of our community a reality.


Bordallo warns new bill would cripple health care

The American Health Care Act of 2017 was passed Friday by House Republicans in a vote of 217 to 213. The bill seeks to repeal the Affordable Care Act, cutting Medicaid spending and changing the incentive structure to reduce government subsidies.

Guam Delegate Madeleine Bordallo believes the bill passed by the House Republican leadership will “cripple health care” around the country and force millions of Americans to lose coverage.

Bordallo said the bill does nothing to address the unique health challenges in the territories, and does not include important provisions that would make health care more affordable and accessible.

“I believe that we must find ways to remove the disparity between the 50 states and the territories in Medicaid and bring down insurance costs,” Bordallo said in a statement yesterday.

The Guamd delegate said she would continue to advocate for the elimination of Guam’s Medicaid cap and providing Medicaid eligibility to Compact of Free Association migrants, and will encourage her colleagues in the Senate to oppose the bill.