The Trump Administration released its budget blueprint for federal fiscal year 2020 last week and, by any measure, it does not contain good news for Medicaid, Medicare, hospitals, or coverage expansion.
A president’s budget – any president’s – is merely a statement of priorities. Congress will draft the main budget document and, with Democrats in control of the U.S. House, the likelihood of sweeping Medicare and Medicaid cuts as the administration proposed is slim.
The administration proposes about $575 billion in Medicare reimbursement reductions over 10 years, with most of the money coming from provider cuts and targeting “wasteful spending.” (The Obama Administration proposed about $400 billion in similar cuts.)
For Medicaid, the president proposes repealing Medicaid expansion funding, requiring able-bodied Medicaid recipients to work, and creating a block grant system for states. The cuts total about $1.5 trillion over a decade but observers say savings from the block grants and other provisions work out to about a $777 billion overall cut over 10 years.
Many members of the Massachusetts congressional delegation slammed the president’s budget proposal. Rep. Richard Neal, who chairs the House Ways & Means Committee that has oversight over Medicare and the budget, was especially critical, saying, "The president’s budget is filled with recommendations that would hurt American families, and his half-trillion-dollar cut to Medicare is one of the most egregious."
AHA President and CEO Rick Pollack said, "Patients should be confident in knowing that their hospital is their lifeline to access care in their community. The cuts proposed today raise serious concerns about how hospitals and health systems can ensure they serve as the safety net for their patients."