Trump’s budget is a complete disaster. With so many cuts that would hurt Americans across the country, here’s just a few of the many cuts to the Department of Health and Human Services that Alex Azar will have to try and defend as he testifies before Congress.

Trump’s budget cuts funding to nearly every agency under HHS, totaling $18 billion or a 21 percent decrease from 2017.

The Hill: “The Department of Health and Human Services would face an $18 billion cut under the budget proposal released by the Trump administration Monday, a 21 percent decrease from 2017. Under the proposal, HHS would get $68.4 billion for the 2019 budget year. Nearly every agency under HHS would see a funding cut.”

Trump’s budget would limit access to existing opioid treatment options and cut $688 million from the Substance Abuse and Mental Health Services Administration.

Vox: “But it also takes some big steps back – by slashing other funding sources that help people access treatment for opioid addiction, particularly through the budget’s attempts to repeal the Affordable Care Act (“Obamacare”) and cut Medicaid.”  

The Hill: “The Substance Abuse and Mental Health Services Administration would face a reduction of $688 million cut, coming out to about $3.5 billion for 2019.”

Trump’s budget takes aim at seniors with a $554 billion cut to Medicare, higher prescription drug costs for 4.5 million Medicaid beneficiaries, and reduced payments for nursing homes.

Washington Post: “As a candidate, Trump repeatedly said he would never cut Medicare, Medicaid or Social Security. Now he proposes cutting Medicare by $554 billion and Medicaid by around $250 billion over the next decade.”

Associated Press: “Some Medicare beneficiaries would pay more for their prescription drugs under President Donald Trump's budget even as the sickest patients save thousands of dollars, a complex trade-off that may make it harder to sell Congress on the plan in an election year … But about 4.5 million seniors in the group just behind them could end up spending more of their own money … They could wind up paying about $1,000 more.”

Bloomberg: “Trump also proposes to cut federal payments to home-health agencies and nursing homes by $80 billion over a decade and to reduce payments to hospitals by nearly $200 billion, including reductions for hospital-owned doctor’s offices.”

Trump’s budget cuts Medicaid spending by $250 billion, repeals the ACA’s Medicaid expansion, and implements limitations to health coverage for many low-income Americans.

Los Angeles Times’ David Lazarud: “But Trump's plan does seek $554 billion in cuts to Medicare spending over 10 years, plus about $250 billion in cuts to Medicaid spending.”

Washington Post: “That's because it also incorporates a rollback of the Affordable Care Act’s Medicaid expansion, as well as suggests block-granting Medicaid and placing a per-person spending cap on it. Those are all moves that would sharply reduce future Medicaid spending and almost certainly reduce health coverage for many low-income Americans.”

Vox: “But the Trump administration has other ideas for Medicaid, too: … Increase beneficiaries’ copayments for improper use of the emergency room ($1.3 billion in cuts over 10 years)”

Vox: “But the Trump administration has other ideas for Medicaid, too: … Allow asset testing, which adds up all the value of a person’s property and belongings, in addition to income as a test of Medicaid eligibility ($2 billion in cuts over 10 years)”

Trump’s budget calls for repealing the Affordable Care Act, which could lead to 20 million fewer Americans having health insurance in 2026.

Vox: “The budget proposes enacting a repeal-and-replace bill that closely resembles the plan put forward by Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA) last fall, which would have turned much of Obamacare’s funding for Medicaid expansion and premium subsidies into block grants for states to create their own health care programs … That plan, you will recall, was projected to lead to 20 million fewer Americans having health insurance in 2026, versus Obamacare, and a $215 billion cut to federal health care spending over 10 years.”

Trump’s budget cuts the Centers for Disease Control funding by over $1 billion, limiting its ability to combat global disease outbreaks.

The Hill: “The administration requested $10.9 billion for 2019 for the Centers for Disease Control and Prevention, a cut of more than $1 billion.”

NPR: “A U.S. program to help other countries beef up their ability to detect pathogens around the world will lose a significant portion of its funding. The ambitious program, called Global Health Security Agenda, was launched in early 2014, aiming to set up an early-warning system for infectious diseases across the world … In Trump's proposal, funding for the program would drop by about two-thirds, from about $180 million each year to about $60 million each year.”

Trump’s budget would bar some health organization that provide abortions from receiving HHS funds.

Wall Street Journal: “On another hot-button topic, the budget would bar some health organizations that provide abortions from receiving funds from the Department of Health and Human Services.”

Trump’s budget does little to address soaring drug prices.

Los Angeles Times’ David Lazarus: “Trump’s Budget Plan Offers Little More Than A Band-Aid For Soaring Drug Prices.”

STAT News: “President Trump’s plan to bring down the price of prescription drugs, released as part of his administration’s budget proposal Monday, made no mention of what his health secretary said is the ‘most important thing’: lowering the actual list prices drug makers set for their products … That’s a far cry from what Alex Azar, secretary of the Department of Health and Human Services, told senators at his confirmation hearing last month that he wanted to accomplish. ‘The most important thing we have to figure out is, can we reverse the incentive on list prices?’ Azar said.”

Trump’s budget would cut nearly $4 billion from the Administration for Children and Families, which provides assistance to families in poverty.

The Hill: “The Administration for Children and Families, which provides assistance to families in poverty, would get $15.3 billion, a decrease of nearly $4 billion.”

The budget would eliminate the Agency for Healthcare Research and Quality, which studies ways to make care more efficient.

McKnight’s Long-Term Care News: “President Donald Trump has unveiled his spending priorities for 2019, releasing a budget that would eliminate 22 programs and agencies — including the Agency for Healthcare Research and Quality — and dramatically reduce funding for others … The agency studies ways to make healthcare more efficient. Its work, ranging from infection control collaboratives to pressure ulcer turning protocols, is widely used by long-term care providers.”