Dear Team –

Earlier this week the Trump Administration released its proposed federal budget for the 2019-2020 fiscal year. As in past years, the budget proposal will be “dead on arrival” in the Congress, and actual federal funding for the next year will depend on upcoming negotiations between the House and the Senate.

Dead on arrival or not, an Administration’s budget proposals does offer a President’s statement of values. It offers an opportunity for a teaching moment, so let’s take it.

The Administration is proposing steep cuts in health care. The President continues a war of attrition against the Affordable Care Act, also known as Obamacare. This year, in addition to major cutbacks in Medicaid, the President also proposes cuts in Medicare – single payer health coverage for people 65 and older, and for younger people with serious, long-term disabilities.

These spending reductions would undercut the health care infrastructure in America, hurting millions of Americans. As mentioned, the Congress is unlikely to go along.

Cut backs in other areas of human need, especially housing, strike at the heart of health care delivery as well. “Housing is Healthcare,” at least in my opinion, so we at CHN focus on federal housing policy as much as on federal health policy. They are tightly connected.

Almost all New Yorkers struggle to find affordable housing in this City’s market. In some U.S. cities, mostly on the West Coast, housing is even tighter. It is a problem, however, in a majority of urban areas across the country.

The most extreme housing deprivation in New York City is seen in the nearly 70,000 New Yorkers without homes – living in shelters, in the subways, and on the streets. And the visible homeless poor are the tip of the iceberg. Many more New Yorkers are living in overcrowded, dangerous dwellings. Even the relatively fortunate tenants living in New York City Housing Authority units are under stress: health threats in public housing are incessant, with dangers ranging from black mold to lead paint to no heat.

This is a national emergency, a real life-threatening emergency. Here is what the President’s budget does in response. For starters, the budget calls for a 16.4 percent cut for the Department of Housing & Urban Development (HUD). It would cap funds for public housing capital repairs (think heat, water, and lead paint removal), raise rents on low-income tenants, and gut the national Housing Trust Fund, which supports the development of affordable housing. The reduction in proposed federal support for housing totals $8.6 billion — the exact amount The President’s budget seeks for a wall on the Mexican budget.

Ignoring America’s housing emergency is an attack on the health of Americans. Without a safe place to live, medical and behavioral health care will not result in good outcomes. No matter the brilliance of a child’s pediatrician, when a patient with asthma returns to a mold filled, overcrowded apartment, she will not get better.

Too many of our patients face this daily reality. That is why at CHN so much of our energy — as medical providers, social workers, Health Homes staff, and others — – goes to help patients find decent housing. But doing so, in this housing market, is like walking up a vertical sheet of ice.

We at CHN want to continue to raise our voices in support of humane public policy, and in resistance to policies that hurt vulnerable people. In our private lives, we can be partisan, at CHN we focus on policy, not partisan politics.

Housing has not always been a partisan fight, and it should not be today. Earlier in my career, a newly confirmed Republican Secretary of Housing and Urban Development, Jack Kemp, asked me to take him to cities to show the plight of homeless people, and models of supportive housing that would make a difference. He cared, and regardless of politics, people do care.

I hope most of you subscribe to CHN’s daily Be Well text. It brings you smart nutrition and wellness tips each day up at noon. Subscribe to that by texting “BWELL” to 877-877.

We are copying this communication tool in policy, starting later this month. CHN’s Policy Institute, launched in 2016, will keep us better informed on key issues facing CHN, our communities, and our patients. Our new mobile subscription service aims to increase staff engagement in local, state, and federal advocacy. Text “CHN POLICY” to 877-877 to receive policy notifications. They will be informative, sometimes amusing, and always on point to make our voices more informed, and more powerful.

Enjoy, finally, a taste of spring this weekend. In addition, of course, a good St. Patrick’s Day. 

-Bob