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The White House on Monday proposed cutting HHS funding by 12 percent in FY2020, cutting Medicaid spending and allowing states to cut benefits.
In a budget request to cut federal spending by $ 2.7 trillion, the Trump administration would give $ 87.1 billion in funding to HHS on Monday. The White House is also aiming to reduce Medicaid spending by nearly $ 1.5 trillion between 2020 and 2029 by canceling the expansion of the Affordable Care Act program and converting global funding into one. global subsidy or per capita ceilings to States.
However, the president's budget is probably dead when he arrives in Congress, where Democrats control the US House of Representatives. Even when Republicans were in power, there was little appetite for severely cutting the favorite programs of some legislators, such as the National Institutes of Health.
The budget provides insight into how the Trump administration is addressing various health issues, including Medicaid.
The White House wants states to have room to change the benefits of Medicaid, including increasing co-payment for emergency visits for non-emergency situations. The budget proposal indicated that this would encourage recipients to use health care resources appropriately.
It also proposes CMS instructions for Medicaid supplementary payments to hospitals to be "supported by reliable and up-to-date data".
The budget would also extend the current reductions in hospital payments to the disproportionate share of Medicaid.
Just as in the 2019 budget, the FY2020 budget budget approves a missing legislation aimed at repealing the Affordable Care Act, conducted by Sens. Lindsey Graham (R-S.C.) And Bill Cassidy (R-La.). The legislation would convert all ACA funding into global grants. This would also turn Medicaid into a per capita capitalization system that would allocate funds according to the state's population.
The legislation was proposed in September 2017, a few months after another effort to repeal the ACA that collapsed. However, the Senate refused to consider the Graham Cassidy bill, because the Republicans did not support it enough. The Senate leadership has not seriously revisited to restore it.
The budget also renews a pre-appeal to improve the integrity of the 340B drug discount program.
"This proposal includes broad regulatory authority for the 340B drug pricing program to establish enforceable standards for program participation and obliges all covered entities to report on the use of realized savings." thanks to the program ", says the budget.
The administration has targeted the program, including MedicBar Part B reimbursement rebates for 340 drugs, due to concerns about how hospitals are using savings from rebates.
The administration also hinted that she wanted to get rid of the "money load". ACA exchange insurers have a practice of recovering cost-sharing reduction payments.
The budget provides for bans on trade where the customer has to pay no premium, a veiled reference to a "money load". The proposal comes a few months after CMS asked whether it should get rid of the "money burden".
The ACA requires insurers to reduce the costs of low-income foreign exchange clients. The federal government was in the habit of reimbursing insurers, but President Trump stopped payments in October 2017.
A majority of states allow insurers to charge the cost of CSR to cash reference plans. The ACA links the amount of income-based subsidies to the second cheapest money plan, which increases the subsidies because the cost of the money plan is very high.
This practice has resulted in increased federal spending for the ACA and attracted the Trump administration.
The hospital groups were already in effect against the draft budget.
"The impact on the care of the elderly would be devastating," said Chip Kahn, president of the Federation of American Hospitals. "Not to mention that massive cuts would dramatically reduce the resources needed to care for low-income Americans and hinder efforts to address the impending shortage of doctors."
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