White House Wants To Reduce HHS Budget
In a long-delayed budget blueprint for federal fiscal year 2027, the White House is asking Congress for a $15.8 billion discretionary budget cut for the Department of Health and Human Services, which is 12.5% lower than this year and eliminates many programs. Major reorganizations are again proposed. A major change would be the move of the growing 340B program to the Centers for Medicare and Medicaid Services (CMS). That is a fair change given the out-of-control nature of the program and the nexus to government program payments at CMS. A new agency, the Administration for a Healthy America, would be established and oversee health priorities currently managed by multiple agencies. That, too, is not a bad idea and should be considered.
The administration says the cuts will eliminate “bloated, woke and inefficient programs” and refocus on core priorities. But Senate Appropriations Chair Susan Collins, R-ME, essentially declared the cuts dead on arrival, criticizing the proposed eliminations and reductions to domestic program spending. The proposed reductions are about half requested last year.
What is driving the reductions? A $445 billion, or 42%, increase in military spending, bringing it to $1.5 trillion. Overall non-defense discretionary spending reductions amount to $73 billion, or 10%. Healthcare would increase at the Department of Veterans’ Affairs, with a proposed $1.5 billion or 9% increase. Major investments in electronic medical records (EMR), AI, and automation are planned.
MedPage Today, Becker’s and Modern Healthcare do a good job in the articles below of detailing cuts throughout HHS and related agencies. The cuts would reduce $129 million from the Agency for Healthcare Research and Quality.
In addition, Healthcare Dive published two articles on the major staff losses at HHS and related agencies and the impacts as an aggressive overhaul agenda rolls out. It says HHS has lost more than 18,000 employees under Trump 47. Experts complain about too little staff to carry out the mission, but my experience in government suggests staff bloat is a real issue and can often actually work against efficiency. The truth is always somewhere in the middle.
Last, President Trump announced that Vice President JD Vance will become the fraud czar. Main focus: benefit rich Blue states.
Additional articles: https://www.fiercehealthcare.com/providers/white-house-floats-125-budget-cut-hhs-fy2027-reiterates-reorganization-plan and https://www.healthcaredive.com/news/cms-tackles-big-policy-changes-with-diminished-workforce/815937/ and https://www.healthcaredive.com/news/one-year-after-hhs-layoffs-a-department-in-disarray/815906/ and https://thehill.com/homenews/senate/5815864-collins-criticizes-trump-budget/?tbref=hp and https://www.medpagetoday.com/publichealthpolicy/healthpolicy/120647 and https://www.beckershospitalreview.com/hospital-management-administration/trump-budget-targets-15-8b-in-hhs-cuts-9-things-to-know/ and https://thehill.com/homenews/administration/5814748-vance-crackdown-democrat-fraud/?tbref=hp
(Some articles may require a subscription.)
#trump #congress #hhs #cms #budgets #healthcare #veterans #fwa
https://www.modernhealthcare.com/politics-regulation/mh-trump-budget-request-hhs-340b-cms
KHN Gives Skinny On Exchange Subsidies
A great article on what you need to know about Exchange subsidies during tax season. A few key things:
- You must file a tax return whether your income requires it or not or you could be denied coverage in the future.
- There is a recoupment cap 2025 if your income is higher than declared during open enrollment, but the cap is lifted for 2026, creating great risk for a major tax bill.
#exchanges #subsidies #healthcare #coverage
Health Affairs Covers Multi-Year Plans
Many have panned the Trump administration’s proposal for multi-year plans. But the criticism is over the edge and multi-year plans remain a good idea for healthcare overall. The experiment is worthwhile. A Health Affairs Forefront Blog discusses the rationale around multi-year health insurance products. Done right it could stabilize risk pools, emphasize primary care and prevention, and lower marketing and administrative costs. The blog discusses ways to ensure people stay covered and bars on nefarious insurer practices to force out sicker cohorts. While the proposal is limited to catastrophic coverage right now, it should be expanded to other tiers of coverage as well. As noted by the blog, barriers do include demand, education, and complexity.
#exchanges #coverage #healthcare #primarycare #prevention
https://www.healthaffairs.org/content/forefront/building-multi-year-health-insurance
— Marc S. Ryan
