The United States Department of Health and Human Services budget for 2018 is a healthy $1,131 Billion. To keep this astounding number in perspective, a trillion dollar plus budget for HHS is nothing new. In 2016 the total outlay for HHS was $1,103 Billion and in 2017 the number will come in close to $1,130 Billion.

The Health and Human Services budget is the backbone of our entire social services system. Here’s how this enormous amount of money will be spent:

At first glance these generous expenditures appear to be good news for social workers and their constituents. However, a more careful reading of the narrative portion of the 2018 HHS budget puts a slightly different slant on our current government’s attitude toward social services.

Let’s Listen Closely…

“The FY 2018 President’s Budget brings Federal spending under control and returns the Federal budget to balance within ten years. Of its total net estimated ten-year savings over this period, the HHS Budget contributes $665 billion in mandatory savings…”

“With responsibility for the major drivers of mandatory spending in the budget, HHS is in a unique position to help lead the Administration’s efforts to rebuild fiscal solvency and to secure the trust of current and future generations of Americans.”

“The Budget begins the process of expanding choices for individuals and families; enabling market forces and competition to encourage innovation and restrain costs; encouraging self-sufficiency; and promoting federalism, allowing States and localities the flexibility they need to serve their populations.”

“The Budget reforms Medicaid funding to States starting in FY 2020 through either a per capita cap or a block grant.”

“…Makes modest reforms that taken together save a net $5.8 billion over the Budget window. The reforms to the Children’s Health Insurance Program ensure the program’s focus on serving the most vulnerable low-income families.”

“The Budget allows HHS to continue to support priority activities at an overall lower level while restoring fiscal discipline and promoting long-term fiscal stability across the Federal Government.”

An Unusual Theme for an HHS Budget Emerges

The 2018 HHS budget redirects the department’s mission toward helping the government cut the deficit and balance the federal budget. Although everyone agrees that this is a noble goal, rarely did the senior management at Health and Human Services consider it their top priority.  The narrative surrounding the 2018 budget metrics tells a cautionary tale of dedication to fiscal responsibility perhaps at a cost to delivering services to constituents. Every caseworker in the country should take notice.