Although the details are scarce, President Donald Trump's proposed budget, "America First: A Budget Blueprint to Make America Great Again" (PDF), paints a dramatic picture for the American science and medical communities that is facing huge potential budget cuts.
If it's been a while since you've had a civics class, the Constitution states that it's Congress that gets to decide how to spend the government's money and how to tax its citizens, so this proposal is not the final word on what goes and what stays. But a President essentially starts the conversation, and for many scientists, it's not a happy topic.
The National Institutes of Health budget would be cut by $5.8 billion, meaning it would lose about 20%. The Environmental Protection Agency would face $2.6 billion in cuts, that's 31% of the agency's budget. The Department of Energy would lose $900 million, or about 20% of its budget. Health and Human Services would see a $15.1 billion or 18% budget cut; as part of that, it shifts costs to industry from the Food and Drug Administration budget. The National Oceanic and Atmospheric Administration would face an 18% budget cut.
It's unclear what would happen to the National Science Foundation. That agency gives out more than $7 billion annually in research grants, accounting for about 20% of federal support to academic institutions for basic research, but didn't get a mention in the budget.
NASA would see a smaller cut by comparison -- a 0.8% decrease from the 2017 budget -- but its Earth Sciences projects would lose about $200 million, and its Office of Education would be dropped.
Trump budget blueprint raises questions about disaster aid
Trump budget blueprint raises questions about disaster aid
The budget also would eliminate entire programs, such as $403 million in health professionals and nursing training programs. It would kill the Global Climate Change Initiative (PDF) and eliminate payments to the United Nations' efforts to fight climate change.
Gone could be the money for the EPA's Clean Power Plan, which cuts carbon pollution from power plants, and more than 50 other programs at that agency alone. The proposal cuts the funds for Superfund cleanup and ditches funding for the Great Lakes Restoration Initiative, which is working to clean up the resource that 35 million Americans rely on for their drinking water.
It also would eliminate the fund that is helping clean up Chesapeake Bay. That program was the largest restoration effort for a body of water in American history and is only halfway through.
The budget suggests that states should shoulder those costs.
The proposal doesn't give a specific funding figure for the Centers for Disease Control and Prevention, but it says it would reform the CDC to give states more control over public health by creating a $500 million block grant that would "increase state flexibility and focus on the leading public health challenges to each state." Experts say that could suggest that states would get the funding, as opposed to the federal agency.
Meals on Wheels could take funding hit in Trump budget
Meals on Wheels could take funding hit in Trump budget
Trump's budget proposal spells out a plan to create a Federal Emergency Response Fund for a rapid response to public health threats like Zika. There's a $20 million increase for the mitigation of lead-based paint in low-income homes, although the budget eliminates the LIHEAP program, which provides heating and cooling assistance to homes in those same communities.
The proposal includes $500 million to expand opioid abuse prevention and treatment efforts, $900 million for the Department of the Interior's US Geological Survey to "focus investments in essential science programs" and a billion for water management efforts. There's a $4.4 billion request for the Department of Veterans Affairs, a 6% increase from its current funding. There's also a mention of an investment in "mental health activities" but no specifics.
The budget would include some money for international health efforts with a promise to support Gavi, the Vaccine Alliance, which works to increase access all over the world. There's also funding for the fight against malaria and HIV/AIDS.
Congress can accept or reject Trump's budget, and lawmakers have the ability to pick and choose what they like from it.
As far as budgets go, Trump's has been compared to President Ronald Reagan's in its conservatism, but Reagan's had a little more "carrot with its stick; this is all stick," budget expert David Wessel said.
And this proposal is a little unusual.
Mixed reception on Capitol Hill to Trump's proposed budget
Mixed reception on Capitol Hill to Trump's proposed budget
"It's an interesting first chapter, but I'm disappointed we don't have the rest of it," said Wessel, who is a senior fellow of economic studies with the independent Brookings Institution. The document doesn't come with the usual pages and pages of tables that Congress will use in its conversation on enacting the budget; that part is only 62 pages (PDF). Without detail on taxes and other plans, it's hard to know how the proposed budget would work. "This is more like a bumper sticker than a budget."
Wessel believes the proposal will have a hard time getting through Congress as it stands now because it cuts programs many constituents depend on and programs Congress has increased, like its effort to increase the National Institutes of Health budget last year.
Science and medical professionals watching the Trump budget process closely had predicted that it could be a tough pill to swallow, but they said they didn't know it would be this hard.