National WIC Association


January 23, 2017

New President: Last Friday, Donald John Trump was inaugurated as the 45th president of the United States. In his 16-minute Inaugural Address, the billionaire hotelier and former reality TV star promised that “America will start winning again, and winning like never before. We will bring back our jobs. We will bring back our borders. We will bring back our wealth. And we will bring back our dreams.” It remains to be seen how the new President will fulfill these promises.

According to reporters at Bloomberg News, President Trump’s priorities for his first few days in office include the following: Repealing the Affordable Care Act (ACA); increasing border enforcement between the US and Mexico; speeding deportation of undocumented immigrants convicted of crimes; halting immigration and refugees from countries such as Iraq and Syria; lifting rules restricting oil and energy production on federal lands; approving the Keystone XL pipeline; cutting off American funding for United Nations climate change programs; nominating a conservative Supreme Court justice to replace Antonin Scalia; withdrawing from the Trans Pacific Partnership (TPP); demanding changes in NATO; and lifting sanctions on Russia in exchange for a deal on nuclear weapons.

Marches around the World: On Saturday, January 21st, to mark President Trump’s first full day in office, over 1 million people around the world marched in support of women’s rights and civil rights. The Washington, DC rally alone, known as the “Women’s March on Washington,” attracted over 500,000 people according to city officials, and hundreds of thousands of additional people participated in an estimated 600 “sister marches” in cities across the United States and the globe.

Organizers of the Women's March on Washington said the demonstrations were scheduled for the day after the presidential inauguration as a direct response to Donald Trump, whose stances on abortion, immigration, climate change and healthcare have troubled participants. Such a display of resistance and solidarity was certainly heartening to all those determined to protect and strengthen women’s rights and civil rights in the United States in the coming years.

Congressional Schedule: Both chambers plan an abbreviated week as House and Senate Republicans are scheduled to travel Wednesday to Philadelphia for a legislative retreat that runs through noon on Friday. Senate Democrats will travel to Shepherdstown, West Virginia, on Wednesday for their own legislative retreat.

Affordable Care Act Repeal Update: During the week prior to the Inauguration, Republicans in both chambers voted to pass a budget resolution for FY 2017 that includes instructions for repealing the Affordable Care Act (ACA). Policymakers will have until this Friday, January 27th to draft portions of the repeal legislation (although this deadline is non-binding). These portions will then be combined into a final piece known as a reconciliation bill, which would only need a simple majority—51 votes—to pass the Senate. It is widely expected that the reconciliation bill will eliminate the billions of dollars provided to the states that have chosen to expand Medicaid eligibility and repeal the subsidies that help lower-income individuals afford insurance through the exchanges, among other ACA provisions.

It was originally understood that Republicans hoped to pass the repeal reconciliation bill by February 20th without offering a replacement bill at the time the repeal is enacted. However, concern from some Republicans and comments from President Trump may lead Republicans to offer a replacement plan at the same time as the legislation to repeal the law. Accordingly, the February 20th timeline may get pushed into March to give Republicans more time to put their replacement plan together.

President Trump commented last week that his Administration’s plan would be released soon after the confirmation of his nominee for Secretary of Health and Human Services (HHS), Congressman Tom Price (R-GA), and that it would provide “insurance for everybody.” In addition, the new president signed an executive order Friday declaring that his administration will seek a “prompt repeal” of the ACA and ordering federal agencies to try to waive or delay requirements of the ACA that Republicans have determined impose economic or regulatory burdens on states, families, the healthcare industry and others. President Trump and Congressional Republicans have still not revealed much of what a replacement to the ACA would look like.

HHS Secretary Nominee Price will face questions from the Senate Finance Committee tomorrow about how President Trump’s still-undisclosed healthcare proposal will deliver on the President’s promise of “insurance for everybody." Multiple other committee hearings this week will challenge various aspects of the ACA, including two hearings tomorrow—a House Ways and Means Oversight Subcommittee hearing on the ACA’s mandate that individuals purchase health insurance and a House Budget Committee hearing on the "failures" of the ACA.

As we follow the ACA debate in Congress, it is important to recognize that repealing the ACA would strip coverage from millions of Americans and remove important consumer protections, jeopardizing the health and financial security of children and adults. Many reports and articles have been issued recently about the devastating impacts of an ACA repeal:

  • A nonpartisan Congressional Budget Office (CBO) Report issued last week says repealing the Affordable Care Act would cause 18 million people to lose insurance in Year One and 32 million in 10 years and cause a doubling in insurance premiums. Read the four page Report here.
  • Families USA has new fact sheets outlining what is at stake in each state if the ACA is repealed.
  • The Center on Budget and Policy Priorities (CBPP) also has state-by-state fact sheets, and a new interactive slider that shows how much progress the states have made in covering their uninsured residents and how much would be lost if the ACA’s coverage expansions are eliminated. CBPP also has great pieces on why certain replacement proposals being floated by Republicans and the Trump Administration – like health savings accounts, high-risk pools, and turning Medicaid into a block grant – would hurt low-income families and strain state budgets.
  • Trust for America's Health has released a special analysis (including state-by-state fact sheets) finding that the Centers for Disease Control and Prevention (CDC) would lose 12 percent of its annual budget if the Prevention and Public Health Fund (Prevention Fund), part of the ACA, were repealed. States would end up losing more than $3 billion over the next five years - from grants and programs supported by the Prevention Fund.
  • An article from the Hill, Repeal and Replace vs the Public's Health, by Mike Fraser, Executive Director, Association of State and Territorial Health Officials, explains the negative repercussions for public health in the US if the Prevention and Public Health Fund is repealed.

As opposition to the repeal of the ACA becomes more vocal, and concerns rise about cuts to Medicaid and Medicare, pressure from constituents will intensify on senators to prevent this damage. That pressure was felt by Senators Collins (R-ME) and Heller (R-NV) two weeks ago when they voted alongside Democrats to oppose amendments to the FY 2017 budget resolution that would have cut funding for Medicare and Medicaid. If all Democratic Senators remain unified, the dissension of 3 Republican Senators would defeat specific ACA replacement plans.


Please see the section below entitled “Letters and Actions to Support Public Health in Our New Political Environment” to see how you can put pressure on your Senators and Representatives to protect the ACA and other important public health legislation in the coming weeks.

Cabinet Updates: Last Thursday, President Donald Trump named Sonny Perdue III, the former governor of Georgia, as his choice for the next U.S. Secretary of Agriculture. Perdue, 70, would succeed Tom Vilsack as Secretary of USDA, who stepped down January 13th. As head of USDA, Perdue would oversee about 100,000 employees and $140 billion across various programs.

Perdue served as Governor of Georgia from 2003 to 2011. As governor, he was known for promoting pro-business policies and working to streamline government to improve efficiency.

One environmental group, Washington-based Friends of the Earth, promptly criticized the nomination, calling Perdue a climate-change skeptic who supported the expansion of massive chicken farms in Georgia while governor. Kari Hamerschlag, a deputy director with Friends of the Earth, had the following to say: "Given Perdue’s position with a global agribusiness trading company and his actions as governor, we are concerned that Perdue will use his position at the USDA to prioritize the profits of big agribusiness and trade over the interests of American farmers, workers and consumers.” While a date has not yet been set for the nomination hearing, Senator Roberts (R-KS), Chair of the Senate Committee on Agriculture, Nutrition, and Forestry, has indicated that his Committee is looking to move quickly on this process. The Senate will also need to confirm more than a dozen additional positions at the USDA, including the Under Secretary for Food, Nutrition, and Consumer Services, who will oversee the Food and Nutrition Service (FNS).

The remainder of Donald Trump’s cabinet continues to take shape. So far, only two appointees have been confirmed: Retired General James Mattis as Defense Secretary and Retired General John Kelly as Secretary of Homeland Security. The following Senate confirmation hearings will take place this week: The Senate Foreign Relations Committee plans to vote today on former ExxonMobil CEO Rex Tillerson’s nomination to be secretary of state; the Judiciary Committee plans to vote tomorrow on Alabama Senator Jeff Sessions’s nomination to serve as attorney general; the Senate Commerce, Science and Transportation Committee plans to vote tomorrow on the nominations of billionaire businessman Wilbur Ross to head the Commerce department and former labor Secretary (under the Bush administration) Elaine Chao to head the Transportation department; and the Banking, Housing and Urban Affairs Committee is scheduled tomorrow to vote on retired neurosurgeon Ben Carson to be Housing and Urban Development secretary. In addition, the Senate Budget Committee and Homeland Security and Governmental Affairs Committee plan hearings on South Carolina Congressman Mick Mulvaney, Trump’s nominee to head the Office of Management and Budget.