The administration released its budget proposal on February 12, 2018. As expected, the proposal includes a number of changes related to health care.
The budget plan revives the Affordable Care Act (ACA) repeal, with a proposal similar to the Graham Cassidy Heller Johnson bill. Specifically, the budget plan proposes a staged repeal and replace, with the replace being a block grant program for states.
In addition to the repeal of the Medicaid expansion, the budget proposal includes other changes to Medicaid, such as:
- Implementing per capita and block grants;
- Continuing work requirements;
- Ending provider taxes; and
- Increasing flexibility around Medicaid benefits, cost sharing, and eligibility.
The budget plan also proposes to end funding to providers that offer abortion services, while increasing funding for the opioid crisis and serious mental illness (including a new grant program). Increased funding for the opioid crisis would be directed to:
- A national media campaign;
- Promoting safer prescribing;
- Supporting state-based prescription drug monitoring programs;
- Research into alternatives for pain management and treatment best practices;
- Addiction prevention; and
- Increased coverage within public programs.
The budget plan also addresses proposals aimed at drug pricing, including opportunities for up to five states to test new approaches to managing prescription drug costs in their Medicaid programs. It also proposes to speed up the approval process for generic drugs and includes changes to Medicare drug coverage.
Other major changes include the following proposed to funding:
- Increased funding for the Federal Drug Administration (FDA), the National Institutes of Health (NIH), and Indian Health Services (IHS)
- Decreased funding for the Centers for Disease Control and Prevention (CDC)
The plan is just a proposal. While these proposed changes will require significant future action before any could be enacted, they do provide insight into the current priorities of the administration.
For those interested in reviewing the full budget proposal, the addendum, and/or the Graham Cassidy Heller Johnson bill, you can find more information on each of these via the following links:
Administration FY 2019 budget proposal
Addendum to the FY 2019 budget proposal
Graham Cassidy Heller Johnson bill
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Published by Lisa Kaplan Howe
Lisa Kaplan Howe (J.D.) is a Senior Advisor who has spent her career working in health law and policy. At PCG, she focuses on statutory and regulatory analysis and strategic advising, particularly related to health care policy. Lisa has provided subject matter expertise to support state health care reform efforts, including policy development and regulatory support for health insurance Marketplaces and state insurance plan management efforts, Medicaid expansion and Medicaid Waivers (including DSRIP Waivers) and State Innovation Waivers. Lisa led PCG’s work with the New Hampshire Insurance Department relative the state’s Section 1115 Medicaid Waiver to provide coverage to newly-eligible adults through the Marketplace and continues to support the states’ Marketplace plan management work. In those roles, Lisa has served as the chief advisor and policy expert related to Medicaid and private insurance law to the New Hampshire Insurance Department, helping to identify, analyze and lead strategic consideration of federal opportunities and requirements. Lisa is also part of the team helping to design Colorado’s Delivery System Reform Incentive Payment (DSRIP) program. Ms. Kaplan Howe also provides broad policy and regulatory support to PCG’s other health care clients across the country, analyzing policy and regulatory developments, providing strategic advice relative to regulatory questions, and drafting policy briefs and position papers. Lisa is a managing editor of PCG’s monthly health practice area newsletter, Health Policy News.
Prior to joining PCG, Lisa served as Policy Director at New Hampshire Voices for Health, where she led legislative and regulatory analysis, strategic planning, and implementation of the organization’s policy agenda. Her work included drafting bills, amendments, testimony, and communications and testifying at hearings. Lisa also held the positions of Private Market Policy Manager and Consumer Health Policy Coordinator at Health Care for All of Massachusetts. While there, she managed private insurance market policy work and was a member of the organization’s internal health reform team. Lisa also practiced law in the Ropes & Gray health care department, advising health care provider and insurer clients.
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