Yesterday, February 12, 2018, the White House released the President’s FY2019 Budget Proposal entitled, Efficient, Effective, Accountable: An American Budget. Additional documents, including summary tables and an appendix are available here – note that this also includes an addendum that reflects the recently passed budget agreement that passed in the Senate last Friday, February 9, 2018.  Moreover, a summary of the major savings and reforms is available here. Lastly, the HHS Budget in Brief document is available for you to review here.

A summary covering the major healthcare highlights from the President’s Budget is available for you to review here. Note that much of the summary text included is from the “Major Savings and Reforms” document provided above, with page numbers provided for further specifics in the HHS Budget in Brief.  

Some of the important provisions included in the President’s Budget include the following:

• The Budget includes a number of proposals that eliminate excessive spending and distortionary payment incentives without harming beneficiaries’ access to care or altering covered items and services;
• The Budget addresses “excessive payment” for post-acute care providers by establishing a unified payment system based on patients’ clinical needs rather than the site of care;
• The Budget proposes to restructure the Office of National Coordinator for Health Information Technology (ONC) by reducing its budget by 36% and focusing resources on the highest health information technology (IT) priorities; and
• The Budget supports a two-part approach to repealing and replacing the Affordable Care Act (ACA), starting with enactment of legislation modeled closely after the Graham-Cassidy-Heller-Johnson (GCHJ) bill as soon as possible. The second part of the Budget proposal includes additional reforms to address unsustainable healthcare spending trends and builds upon the GCHJ bill to make the system more efficient. This includes proposals to align the growth rates for the Market-Based Health Care Grant Program and Medicaid per capita cap and block grant with the Consumer Price Index (CPI-U). 

As a reminder, the President’s budget is largely a policy messaging document and it is not binding on Congress. While it helps set the Administration’s agenda and lays out specific proposals the Administration would like Congress to consider, the President’s budget itself never receives a vote in Congress. Congress’ process for federal spending for FY2019 – which begins on October 1, 2018 – would normally include a budget resolution to set topline spending numbers, but that is not expected to occur this year. Instead, the bipartisan budget deal that was recently reached will set the topline numbers for the Appropriations Committees to work from as they craft the 12 appropriations bills.