President Trump, the CDC Budget, and Fiscal Irresponsibility

David Super

            The President’s critics have savaged his response to the novel coronavirus outbreak.  Certainly his obsession with the stock market, his assignment of his science-resistant Vice President to lead the coronavirus task force, and his efforts to restrict the flow of expert information are deeply disappointing.  The exploitation of this crisis to promote more ill-targeted tax cuts and anti-immigrant measures is shameful.  The world lost its chance to prevent a coronavirus pandemic when one illiberal regime prioritized avoiding political embarrassment over the public health; ours seemed determined to repeat that mistake. 

            A narrower but still important question that has arisen about whether the President has cut the budget of the Centers for Disease Control.  The Guardian ran a piece by former Labor Secretary Robert Reich entitled “Coronavirus is bad enough – Trump's cuts have made the danger far worse,” although its text describes only cuts the President has proposed for next fiscal year.  Some fact-checkers have criticized Democratic presidential candidates for speaking as if those cuts had already been enacted. 

            CDC’s budget illustrates a broader pattern that has replicated itself numerous times across the federal budget.  To see this, we should examine the CDC’s budget over the past ten years.  This exercise has value beyond the immediate crisis because the CDC is representative of federal government activities more broadly:  few people think much about it most of the time but we urgently want it to be strong and effective when a crisis arises.  Were the current crisis of a different type, we would be focusing on some other agency with the same sense of urgency. 

            In fiscal year 2010, the main CDC account received $6.7 billion.  There is no reason to believe that was the “right” number under any particular set of norms, but it is far enough back to provide a useful point of comparison for subsequent events.  (I am focusing on the main CDC account rather than the total CDC budget to focus on activities most relevant to the current crisis and to filter out some, although by no means all, of the volatility resulting from one-time needs and from activities being transferred into or out of the CDC’s budget.  The story is not significantly different if one aggregates all CDC accounts.  All figures here are in budget authority.) 

            By 2012, the CDC’s budget had shrunk to $6.5 billion as Republicans took control of the House of Representatives.  House Republicans extracted reductions in non-defense discretionary spending from President Obama as their price for approving increases to the debt limit.  Another concession they won was the Budget Control Act of 2011, which resulted in across-the-board discretionary cuts (“sequestration”) in 2013.  That reduced the CDC to less than $6 billion, an 8.8% cut in a single year. 

            For the next several years, many domestic discretionary programs stayed close to their sequestration levels, sometimes with modest inflation adjustments.  The CDC might well have suffered a similar fate but for the Ebola epidemic in west Africa.  Because the CDC possessed much of the federal government’s expertise on communicable diseases, President Obama and Congress routed a large part of the funding for this country’s response to Ebola through the CDC.  Its budget returned to $6.7 billion in 2014 and shot up to $8.7 billion in 2015.  These increases were facilitated by two-year bipartisan agreements that traded cuts in entitlement spending for a modest relaxation in caps on defense and non-defense discretionary spending. 

            As the crisis receded, the CDC’s budget fell to $7.6 billion in 2016 and $7.2 billion in 2017.  In theory, fiscal year 2017 should have been the last year whose funding President Obama would have negotiated with Congress; in fact, he and congressional Republicans never came close to agreement and final spending levels were set in May 2017 by President Trump and Congress.  Although the nominal level for 2017 was greater than that for 2010, it actually provided the CDC with significantly less purchasing power:  adjusting the CDC’s 2010 budget for inflation would have required almost $7.5 billion by 2017. 

            OMB Director Mick Mulvaney, a former congressional “deficit hawk”, recently admitted that Republicans care about deficits only when a Democrat is in the White House.  Sure enough, they have been relatively lenient with discretionary spending for both defense and non-defense accounts since President Trump took office.  One can see this in the CDC’s budget, which rose to $8.0 billion in 2018 before sliding to $7.3 billion and $7.6 billion the last two years.  This year’s CDC appropriation is roughly $200 million less than in 2010 after adjusting for inflation.  It is virtually the same in nominal terms, and a bit less than $400 million dollars after adjusting for inflation, relative to the 2016 figure in the last annual appropriation President Obama signed.  A truly apples-to-apples comparison would require removing spending on the Ebola crisis from the 2016 figure and spending on the opioid crisis from current figures as well as adjusting for transfers of funding and responsibility.  That would require a deep dive into the fine points of the CDC’s budget but probably not change the bottom line much. 

            It therefore seems fair to say that the CDC has been financially weakened under President Trump’s watch, although not dramatically so.  On the other hand, the White House’s furious denials that he cut the CDC are a bit hard to accept when he has repeatedly tried to do just that.  His budget for fiscal year 2021 calls for cutting the CDC budget to $6.4 billion, a 21% cut in purchasing power from 2010 and a 24% real cut from the 2016 level.  Last year, his budget would have cut the CDC’s budget to $6.1 billion.  The year before that, his budget proposed cutting the CDC to $5.2 billion.  And his first budget proposed $5.9 billion for the CDC.  If the CDC’s budget has only shrunk by moderate amounts under President Trump, it certainly is not for his lack of trying to do much more. 

            Moreover, this is in no way a complete accounting of President Trump’s treatment of the CDC.  Agencies can be undermined in many different ways.  President Trump’s first CDC director resigned after it was disclosed that she had bought tobacco stocks after taking her position, creating an untenable conflict of interest.  President Trump’s current CDC director’s appointment was opposed by some public health organizations based on accusations of scientific misconduct and his advocacy of HIV/AIDS policies based on religious teachings rather than science.  I am not qualified to assess the merits of these concerns. 

            The broader lesson here is that our current approach to funding federal programs is not just irrational but dangerous.  No one – and certainly not generalists like voters, journalists, Members of Congress, and Presidents – can possibly know what all the agencies in the federal government do.  We thus have no basis for assuming that continual cuts to funding for non-defense discretionary programs can be achieved without harm.  Today, in light of the coronavirus epidemic, starving the CDC looks foolish.  Were the headlines instead about collapsing bridges, or contaminated food, or leaking nuclear power plants, our parsimony with other agencies would get the attention.  One of the most frustrating aspects of the Benghazi embassy tragedy is the near-universal failure to mention the role of deep cuts in diplomatic security funding. 

            We need to abandon the ill-informed, and often tragically wrong, assumption that there is always fat to be cut in federal programs.  Where specific excesses are identified, or where we decide we want to curtail a particular activity, by all means we should cut.  But budgetary caps requiring unidentified cuts in federal programs’ purchasing power are much more likely to hollow out agencies we may need than they are to eliminate actual waste.  

@DavidASuper1
Posted 6:14 PM by David Super [link]