Dissecting the effects of Trump's budget, from cancer to rural poor to meals

"Forget about the moonshot. What about everything on the ground?" said George Demetri, an oncologist at Dana-Farber Cancer Institute in Boston. Among people who work in the life sciences, Demetri said, "there is a stunned speechlessness."

The budget blueprint released Thursday did not include specific numbers for individual NIH institutes, such as the National Cancer Institute. Still, the proposed cuts represent a sharp turnaround from the Obama administration as well as congressional supporters, who pressed for more NIH funding in recent years.

"From cancer moonshot to crater in the stroke of a pen," tweeted Paul McGee of the American Cancer Society.

Many research advocates predict — and hope — that such large cuts will face opposition in Congress. Officials at academic medical centers and other research facilities already are contacting lawmakers.

"Thank goodness … the legislative branch has shown strong support for NIH," said Jon Retzlaff, managing director of science policy and government affairs at the American Association for Cancer Research.

"We hope this budget is dead before it even arrives," he said.

The Trump administration's plan to eliminate funding for a program that addresses major environmental and health threats in the Great Lakes would have a devastating impact on millions of Canadians, officials said.

The White House's 2018 budget proposal would, if approved by Congress, gut the Great Lakes Restoration Initiative, a federal program that has helped to remove water pollution and harmful algae on both sides of the border. The issue could become one more point of friction between the U.S. and Canada, already divided over trade and immigration.

The budget proposal, which reflects Trump's wish to drastically reduce the size and scope of the Environmental Protection Agency, has dismayed the Canadian government, which cooperates with the United States to clean up and protect the Great Lakes. The lakes are the source of drinking water for 45 million people — including 10 million in Ontario.

"We have done so to protect the health and economies of communities around the Great Lakes. We must now pursue that commitment to keep protecting this precious resource," said Catherine McKenna, Canada's environment and climate change minister.

Since the program was established in 2009 by President Barack Obama, more than $2.2 billion has funded more than 2,000 projects across eight states. The projects have been aimed at removing toxic waste, restoring wildlife habitats and girding against invasive species. Canada contributes more than $13 million annually for Great Lakes restoration.

In rural Appalachia, people are so poor that there is a federal program dedicated to lifting them out of poverty. Through the Appalachian Regional Commission, the government pitches in on projects that these rural communities badly need but can't quite afford — fixing roads, building computer labs, training workers and opening health clinics.

These efforts have become so widely admired that in recent years Congress launched, with bipartisan backing, sister agencies to help other rural regions stuck in generational cycles of poverty. Together the programs spend about $175 million each year bringing jobs and opportunities to places that long have felt left behind.

President Donald Trump, who won rousing victories in these same parts of rural America, would eliminate that funding.

In his budget outline for 2018, none of the rural development agencies — the Appalachian Regional Commission, the Delta Regional Authority, the Northern Border Regional Commission — would receive any money.

In the context of Trump's other budget goals, the money at stake is paltry. What the rural development agencies spend in a year is a third of 1 percent of Trump's proposed $54 billion bump in the military budget.

More than 37 million people would be affected in the 698 counties where the agencies work — in Appalachia, the Mississippi basin, and rural northern New England — places where the poverty rate is 33 percent higher than the national average.

Meals on Wheels, the popular service that provides food to the elderly, faces a sharp funding cut under President Donald Trump's budget proposal, drawing protests from congressional Republicans and Democrats.

The exact size of the cut is unknown, but White House Budget Director Mick Mulvaney said the government "can't spend money on programs such as Meals on Wheels just because they sound good — and great."

Mulvaney's comments caused consternation as lawmakers from both parties vowed to protect the program, which serves nearly a million meals per day nationwide through a network of more than 5,000 local programs. More than 2.4 million older Americans are served each year, including more than 500,000 veterans.

Rep. Gus Bilirakis, R-Fla., said Friday that he's "been a fan of Meals on Wheels forever" and even delivered food. Rep. Linda Sanchez, D-Calif., said Trump's plan was "literally taking food away from seniors."

Trump's budget plan would cut hundreds of millions of dollars for the Department of Health and Human Services and the Department of Housing and Urban Development, both of which fund Meals on Wheels

"Cuts of any kind to these highly successful and leveraged programs would be a devastating blow to our ability to provide much-needed care for millions of vulnerable seniors in America," said Ellie Hollander, president and CEO of Meals on Wheels America.

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