Politics Trump Policy Once Again in Budget Debate, by Veronique de Rugy

Modesto Morganelli
Marzo 14, 2019

But some of the Medicare cuts have received bipartisan support in the past, including halting hospitals from bumping up their Medicare payments by acquiring doctors' practices (a method CMS has tried to crack down in the past with its site-neutral payment proposals) and lowering spend on prescription drugs.

House Democrats said Tuesday they will reject a portion of President Trump's budget that would convert Medicaid from an open-ended entitlement to fixed amounts of money for states, though they do fear the administration will go around them.

Tricia Neuman of the nonpartisan Kaiser Family Foundation said the Medicare reductions in this year's budget are larger than what Trump proposed last year.

The White House budget also includes provisions meant to lower prescription drug spending and allocates $4.8 billion to stem the tide of the opioid epidemic, along with $291 million next year to fight HIV/AIDS.

President Donald Trump called for severe cuts for domestic programs, including housing for lower-income families, in his record $4.75 trillion proposed budget for 2020.

He cast the proposed cut as the president's attempt "to balance his books" after giving more than $2 trillion in tax cuts to major corporations and wealthy Americans.

"We're also finding waste, fraud, and abuse", Vought added. The cost-saving covers some of the mandatory programs such as Medicaid, Medicare, and programs on federal health care.

Some programs he pledged to protect when he was running in 2016 are singled out for cuts in his latest budget, including the Medicare healthcare program for the elderly and the Medicaid healthcare program for the poor and disabled, Democrats said.

"Over the next 10 years, we are confident that the economic policies of this administration ... will more than pay for the costs of the tax cuts", said Vought. Indeed, it would have capped federal spending on the entire program.

But his plan to repeal and replace "Obamacare" involved major Medicaid cuts. In the end it couldn't pass a Republican-controlled Congress.

Trump's proposals met with immediate criticism from the host of candidates for the Democratic presidential nomination.

"Providers are likely to say that the proposed cuts are likely to harm patient care, especially if they think there is some possibility that Congress will adopt them", said Neuman. That includes shifting roughly $269 billion in funding for training medical residents and payments to hospitals for caring for the uninsured to the Department of Health and Human Services' budget.

The group also said it's concerned about that some of Trump's Medicare drug proposals could create winners and losers among beneficiaries.

As part of the spending-cut initiative, the administration also has identified a number of wasteful and ineffective programs, such as Job Corps.

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