Trump budget proposal would slash Medicaid – ModernHealthcare.com

President Donald Trump’s budget proposal to be presented Tuesday reflects the same $800 billion cut to Medicaid over a decade that was in the bill which last month passed the House. The Congressional Budget Office estimates that could lead to 10 million people losing healthcare insurance over 10 years.

According to the Associated Press, the White House will also implement a federal order that allows states to impose work requirements on people who receive Medicaid and food stamps.

By cutting Medicaid, Trump is rejecting the calls of some Senate Republicans who asked him not to stop expansion of Medicaid, which funneled billions into cash-strapped states. Even the most ardent opponents of the Affordable Care Act held out their hands when the federal government offered to subsidize the cost of expanding eligibility for Medicaid.

Earlier this month, a bill to repeal the ACA that included massive cuts to Medicaid, passed by a razor-thin 217-213. Key Republicans have signaled they are not interested in another round of cuts to the program.

“I would think that the health care bill is our best policy statement on Medicaid going forward,” said Rep. Greg Walden (R-Ore.), chairman of the House Energy and Commerce Committee, which has jurisdiction over the program.

Details on Trump’s budget will not be publicly released until Tuesday, but the Associated Press and other outlets were briefed by White House budget director Mick Mulvaney.

The fleshed-out proposal follows up on an unpopular partial release in March that targeted the budgets of domestic agencies and foreign aid for cuts averaging 10%—and made lawmakers in both parties recoil.

The new cuts are unpopular as well.

Trump’s budget plan promises to balance the federal ledger by the end of a 10-year window, even while exempting Social Security and Medicare retirement benefits from cuts. To achieve balance, Mulvaney relies on optimistic estimates of economic growth, and the surge in revenues that would result, while abandoning Trump’s promise of a “massive tax cut.”

Instead, the Trump tax plan promises an overhaul that would cut tax rates but rely on erasing tax breaks and economic growth to end up as “revenue neutral.”

Trump’s full budget submission to Congress is months overdue and follows the release two months ago of an outline for the discretionary portion of the budget, covering defense, education, foreign aid, housing, and environmental programs, among others. Their budgets pass each year through annual appropriations bills.

Trump’s earlier blueprint proposed a $54 billion, 10% increase for the military above an existing cap on Pentagon spending, financed by an equal cut to nondefense programs. Those cuts rang alarm bells for many Republicans, who were particularly upset about proposals to eliminate community development block grants, slash medical research and eviscerate foreign aid.

Trump’s GOP allies rejected such cuts when wrapping up long-overdue legislation for the current budget year, which ends Sept. 30. There’s little sign they will have a change of heart now, especially with Trump’s administration in turmoil and his poll ratings at historic lows.

“The budget’s a starting point. We’ll go to work from there,” said Sen. John Hoeven (R-N.D.) a member of the Senate Appropriations Committee.

Republicans controlling Congress have delayed action on their companion budget measure, waiting for Trump to go first. This year’s budget debate, Republicans hope, would grease the way for a major overhaul of the loophole-cluttered tax system. But House conservatives also want to embark on a round of cuts to benefit programs and are open to Trump’s suggestions for cuts to mandatory programs such as federal employee pensions.

Presidential budgets are mere suggestions, and the White House has discretion to assume higher economic growth rates of up to 3 percent or so under Trump’s agenda of tax changes, loosened regulations and infrastructure spending.

Tuesday’s budget will also include proposals such as paid leave for parents after the birth or adoption of a child, a $200 billion infrastructure plan that Trump officials claim could leverage, along with private investment, up to $1 trillion in construction projects, and funding for Trump’s oft-promised wall along the U.S.-Mexico border.

The Associated Press contributed to this report.

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