Trump budget to call for $610 billion in Medicaid cuts

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President Trump will propose massive cuts to the Medicaid program for fiscal year 2018, according to a budget document posted by the Department of Health and Human Services.

In total, the budget proposes cutting Medicaid spending by $610 billion over 10 years. That’s on top of more than $800 billion in cuts called for under the House-passed ObamaCare repeal bill, the American Health Care Act.  

The HHS budget, which was posted online and then quickly deleted, also calls for changing how Medicaid is financed. The proposal would transition the joint federal-state program from a traditional entitlement to either a block grant or per capita cap. It would also allow states to impose work requirements for certain Medicaid beneficiaries.

“This proposal will free States to advance solutions that best serve their unique populations — for example, encouraging work, promoting personal responsibility, and meeting the spectrum of diverse needs of their Medicaid populations,” the budget document said.

The administration will also call for a two-year reauthorization of the Children’s Health Insurance Program, which helps families who make too much to qualify for Medicaid. Funding for CHIP currently expires Sept. 30.

The full budget is slated for release on Tuesday morning.

“The only official version of the HHS budget will be released by the Office of Management and Budget at 11:00AM tomorrow. At that time, Budget Director Mulvaney will hold a press briefing and address any questions,” said Alleigh Marré, the national spokeswoman for HHS.

Trump pledged during the presidential campaign not to cut Social Security, Medicare or Medicaid.

The cuts in the AHCA could result in about 14 million people over the next decade losing Medicaid benefits, according to an earlier Congressional Budget Office analysis.

The AHCA would also end ObamaCare’s Medicaid expansion in 2020, which is a problem for some moderate senators who would like to see a less abrupt transition.

When asked Monday if the Medicaid cuts could survive Congress, Senate Majority Whip John Cornyn (R-Texas) said, “No, I think the tradition is presidents write budget proposals and that the Senate and the House substitute their own, and so I wouldn’t expect that would carry the day.” 

He added that “almost every president’s budget proposal I know of is basically dead on arrival.” 

Also notable:  

  • The administration is proposing a $5.8 million cut to the National Institutes of Health (NIH), a recommendation that has been rejected by both Republicans and Democrats. Rep. Tom Cole (R-Okla.), the chairman of the Appropriations Subcommittee overseeing NIH’s budget, said Monday that he doesn’t think Congress will pursue those cuts. “I don’t think it’s a wise choice,” he said. 

  • Both the Centers for Disease Control and Prevention and the Food and Drug administration (FDA) could see $1 billion cuts each.

  • The proposal does not include any direct cuts to Medicare, showing that Trump is sticking to his campaign promise of protecting the entitlement program.

– This story was updated at 6:48 p.m.

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