The AAP is urging Congress to prioritize children’s health and well-being and warning about the harm of making cuts to key programs as lawmakers in the U.S. House of Representatives consider a budget reconciliation package.
“We already know that our nation underinvests in children, and many families face barriers to accessing what they need to help their children thrive,” said AAP President Susan J. Kressly, M.D., FAAP. “Any cuts to federal programs that support children and pediatric health care, let alone the proposed drastic ones, threaten the health of children in every community.”
Dr. Kressly sent a letter to congressional leaders on May 10 calling for protection of Medicaid, the Children’s Health Insurance Program (CHIP), Supplemental Nutrition Assistance Program (SNAP), child tax credit, Temporary Assistance for Needy Families (TANF) and Social Services Block Grant program in addition to urging evidence-backed best practices for the care of immigrant children.
The budget resolution adopted by the House of Representatives last month would allow up to $880 billion in cuts from 2025-’34 to Medicaid, which insures 37 million children and teens. Proposals also would limit access to care and shift costs to states. Dr. Kressly called Medicaid and CHIP “critical lifeline programs.”
“Whether by capping or reducing the federal share of Medicaid costs, limiting state financing models, imposing work requirements, increasing eligibility checks, or making other changes, Congress cannot cut hundreds of billions of dollars out of Medicaid and CHIP without harming children,” Dr. Kressly wrote.
The AAP has long fought to protect Medicaid and CHIP. Earlier this year, it joined hundreds of other organizations in a letter to congressional committee members calling on them to reject proposed cuts to Medicaid and CHIP and also joined other medical groups in a statement supporting Medicaid.
In the May 10 letter, Dr. Kressly also decried efforts to reduce funding or change eligibility for SNAP, which serves about 20 million children and reduces food insecurity by as much as 30%. The House budget resolution allows up to $230 billion in cuts over 10 years.
“Children in food-insecure households are more likely to have poorer overall health, worse academic performance, and higher risk of developmental problems and obesity,” Dr. Kressly wrote.
Likewise, the child tax credit, TANF, Social Services Block Grants provide crucial support for millions of children and need to be preserved, she said.
She also called for protection of children in immigrant families who represent about one in four children in the U.S. The AAP is concerned about proposals that would expand family detention and those that would result in unaccompanied children remaining in the custody of the Office of Refugee Resettlement for longer periods.
“There is no evidence that any amount of time in detention is safe for children, and in fact, detention itself poses a threat to child health,” she said.
The House and Senate will refine the details of their budget plan during the reconciliation process. That includes meetings of House committees that will negotiate spending plans for the programs under their purview.
“Congress has a pivotal opportunity in budget reconciliation to invest in the future of our nation and ensure that children and families can thrive,” Dr. Kressly wrote. “… We urge Congress to expand supports for families, and not to advance harmful policies that would weaken or shrink key programs that support families, nor immigration policies that threaten children’s health.”
President Donald J. Trump on May 2 released his blueprint for the 2026 federal budget, a nonbinding plan often called the “skinny budget” that connotes an administration’s priorities. That plan calls for a 26.2% reduction in spending by the U.S. Department of Health and Human Services (HHS), which has cut thousands of employees since Trump took office in January.
The HHS cuts in the skinny budget would amount to $33.3 billion and include reductions for the Centers for Disease Control and Prevention and the National Institutes of Health. Congress will make the final decisions on spending.
The plan would cut $163 billion in federal spending on non-defense programs, including a 54.5% reduction in spending by the Environmental Protection Agency and 15.3% by the Department of Education. It also would hinder or eliminate programs that address school readiness, mental health support, injury prevention, environmental health and workforce development, according to an AAP analysis.
Trump must sign a budget bill by Sept. 30 to avoid government shutdown unless a continuing resolution is passed to allow negotiations to continue.
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