Senate/Trump Would Cut Medicaid by $1 Trillion to Medicaid, Medicare, Hike SUD Services by $500m

Monday, October 23, 2017

Senate Moves Ahead on GOP Budget with Medicare, Medicaid Cuts
By Andrew Taylor, Associated Press October 17, 2017

WASHINGTON (AP) — The Senate (NYAPRS updated edit) has moved) ahead on a Republican budget plan, a critical step in President Donald Trump and the party’s politically imperative drive to cut taxes and simplify the IRS code.

The nonbinding budget plan would permit Republicans to pass follow-up tax cuts later this year that would cost up to $1.5 trillion over the coming decade. The plan cleared a procedural hurdle in the Senate on a party-line vote of 50-47.

The plan breaks with longstanding promises by top Republicans like Senate Majority Leader Mitch McConnell and Speaker Paul Ryan that the upcoming tax drive won’t add to the nation’s $20 trillion debt. Once the budget plan passes through the GOP-controlled Congress, the House and Senate can then advance a follow-up tax overhaul measure without fear of a filibuster by Senate Democrats.

“It is crucial that Congress approve this fiscal framework in order to eliminate the dated and stifling tax policies that are holding back our nation,” said Budget Committee Chairman Mike Enzi, R-Wyo.

The budget plan calls for $5 trillion in spending cuts over the decade, including cuts to Medicare, Medicaid and the Obama-era health care law, though Republicans have no plans to actually impose those cuts with follow-up legislation…..

The spending cuts in the measure include $473 billion from Medicare and more than $1 trillion from Medicaid. Although the budget plan is nonbinding, it puts Republicans and Democrats on record about its policies.

If the measure’s politically difficult cuts were implemented, the budget deficit would drop to $424 billion after 10 years and average about $540 billion a year over the life of the plan, the Congressional Budget Office estimates.

Republicans use different math, relying on optimistic predictions of economic growth that average 2.6 percent a year, while ignoring growing, chronic deficits run by Social Security to claim that their budget could actually generate a surplus by 2026.

“The Budget Committee expects that enactment of pro-growth policies could generate sufficient economic growth to offset” the $1.5 trillion tax cut, according to the panel’s budget report…..

Associated Press writer Marcy Gordon contributed to this report.

Federal Health Department Would Face a Nearly 18 Percent Cut
By Amy Goldstein Washington Post

The Department of Health and Human Services would receive $69 billion under the president’s budget proposal, a reduction of 17.9 percent that would send spending in one of the government’s largest and most sprawling departments to its lowest level in nearly two decades.

More than a third of the $15.1 billion in cuts would affect the National Institutes of Health, the government’s main engine of biomedical research, which has long enjoyed strong bipartisan support in Congress.

The spending document prepared by the Office of Management and Budget provides only a glimpse into the new administration’s intentions for HHS. In a break with budgetary tradition, the document excludes funding for Medicare and Medicaid benefits — currently totaling about $1 trillion — the vast public insurance systems for older and poor Americans known as “mandatory” programs in federal budget parlance.

And there is no mention of certain major programs. Among them are Temporary Assistance for Needy Families, the country’s main welfare program of cash assistance, and Head Start, a program benefiting low-income preschool children.

The proposed budget would increase spending on substance-abuse services by $500 million to help prevent and treat opioid addiction. And it would create an emergency fund to help respond to disease outbreaks, though it does not specify how much money such a fund would receive or whether the money would be diverted from other parts of the U.S. Centers for Disease Control and Prevention.

The budget would eliminate longtime targets of conservatives: the Low Income Home Energy Assistance Program as well as the Community Services Block Grant, a 1970s-era strategy to lessen poverty.

In the Food and Drug Administration, the budget anticipates a doubling of the reliance on fees charged to companies applying for permission to sell new medical products to help cover the cost of reviewing them.

The proposed cuts to NIH represent 19 percent of its $30.3 billion budget for “discretionary” programs. The spending plan calls for a “major reorganization” of the 27 NIH institutes and centers, though it does not spell out the changes — with one exception. It would abolish the Fogarty International Center, a $69.1 million program dedicated to building partnerships between health research institutions in the United States and other countries.

The plan also would fold into NIH the Agency for Healthcare Research and Quality, a free-standing agency within HHS devoted to fostering research evidence to improve health care’s quality, safety and accessibility.

In addition, the summary tables of the budget document lists the 2018 budget request for HHS as $65.1 billion. The discrepancy was not explained in the document.