President Trump released his proposed FY21 budget last year and it is remarkable for the ferocity with which it attacks Medicare and Medicaid. Presidential budgets are essentially vision statements with no real statutory authority; the real budget power lies with Congress. But provisions in the presidential budget that can be accomplished by rulemaking at federal agencies, often eventually show up in such rulemaking.
The administration proposes the following reductions over 10 years: cutting Medicare and Medicaid graduate medical education funding by $52.2 billion; cutting hospital uncompensated care by $87.9 billion; reducing Medicare coverage of bad debt by $33.6 billion; reforming the post-acute care payment system that would result in a $101.5 billion cut; paying hospital-owned physician offices located off-campus at the physician office rate, resulting in a $47.2 billion cut; paying on-campus hospital outpatient departments at the physician office rate for certain services, resulting in a $117.2 billion cut; and continuing the Medicaid Disproportionate Share Hospital allotment reductions by $32.4 billion.
In a statement, AHA President and CEO Rick Pollack said, "Hospitals and health systems remain steadfast in our commitment to stand up for patients and families. Every year, we adapt to a constantly changing environment, but every year, the administration aims to gut our nation's healthcare infrastructure.”