Breaking News
July 17, 2018 - New machine learning framework predicts effects of genetic mutations in ‘dark matter’ regions
July 17, 2018 - Plant-based products fail to have positive impact on blood pressure during clinical studies
July 17, 2018 - Electronic system to speed up facial pain diagnosis may improve quality of life and save money
July 17, 2018 - Women Often Unaware of Their Hospital’s Religious Affiliation
July 17, 2018 - New AASM guideline recommends use of actigraphy for sleep disorders
July 17, 2018 - CRISPR editing reduces repetitive behavior in mice with a form of autism
July 17, 2018 - Scientists use magnets to detect cancer
July 17, 2018 - Microfluidic chip to detect sepsis proves successful in clinical study
July 17, 2018 - Research provides better understanding of mechanisms underlying memory storage
July 17, 2018 - A Multi-Modal Approach for the Early Detection of Breast Cancer
July 17, 2018 - Mailing colorectal cancer tests to patients increases screening rates, report researchers
July 17, 2018 - Scientists find possible sources of medicinal and antimicrobial drugs
July 17, 2018 - Molecules formed when the body metabolizes omega-3 fatty acids may inhibit cancer
July 17, 2018 - Efficient communication between hospitals improves patient safety and reduces mortality
July 17, 2018 - Study highlights potential of fetal gene therapy to prevent lethal neurodegenerative disease
July 17, 2018 - For Americans, in Science They Trust
July 17, 2018 - Combating HIV/AIDS | NIH MedlinePlus the Magazine
July 17, 2018 - Study shows minorities widely underrepresented in autism diagnoses
July 17, 2018 - Multigene testing replacing BRCA tests for breast cancer risk | News Center
July 17, 2018 - Pre-clinical pilot study shows promising results of ‘concussion pill’
July 17, 2018 - Researchers reduce size of tumors in mice by artificially activating the brain’s reward system
July 17, 2018 - New study documents symptoms of people before they acquire multiple sclerosis
July 17, 2018 - Researchers discover why CRISPR gene editing sometimes fails
July 17, 2018 - New finding may hold key to better understand the complexities of neurological disorders
July 17, 2018 - The Current issue of “The view from here” is concerned with Novel Targets.
July 17, 2018 - Fighting the Flu with a Universal Vaccine
July 17, 2018 - Key social reward circuit in the brain impaired in kids with autism | News Center
July 17, 2018 - Insight into causes, types and treatment of aphasia
July 16, 2018 - Quark Pharmaceuticals, Inc Announces First Patient Dosed in Phase 3 Clinical Trial of QPI-1002 for Prevention of Acute Kidney Injury Following Cardiac Surgery
July 16, 2018 - NSAIDs shown to have causal role in cardiovascular risk of patients with osteoarthritis
July 16, 2018 - PET scan tracer predicts success of cancer ‘vaccine’ | News Center
July 16, 2018 - Parents struggle with what to do when their child has headache, shows study
July 16, 2018 - Outrageous or overblown? HHS announces another round of ACA navigator funding cuts
July 16, 2018 - Weight loss surgery may impact individual’s risk of developing cancer, shows study
July 16, 2018 - Alexion Submits Application for Priority Review and Approval of ALXN1210 as a Treatment for Patients with Paroxysmal Nocturnal Hemoglobinuria (PNH) in the U.S.
July 16, 2018 - Restoring epigenetic balance reinstates memory in flies with Alzheimer’s disease symptoms
July 16, 2018 - Magnetized wire could be used to detect cancer in people | News Center
July 16, 2018 - Non-surgical management found to be feasible option for penetrating kidney trauma
July 16, 2018 - California clinic screens asylum seekers for honesty
July 16, 2018 - FDA Approves Xtandi (enzalutamide) for the Treatment of Men with Non-Metastatic Castration-Resistant Prostate Cancer (CRPC)
July 16, 2018 - Can nanotechnology help treat Alzheimer’s?
July 16, 2018 - Researchers identify protein essential for making stem cells | News Center
July 16, 2018 - Severe childhood infections linked with lower school achievement in adolescence
July 16, 2018 - Radiologist discusses causes, treatments of varicose veins
July 16, 2018 - Researchers develop nanostructured surface to accelerate wound healing after dental implants
July 16, 2018 - New non-invasive procedure to reposition kidney stones could benefit astronauts
July 16, 2018 - Attending Surgeon Influences Genetic Testing in Breast Cancer
July 16, 2018 - Medical doctors with addictions fear professional repercussions if they seek treatment
July 16, 2018 - 5 Questions: John Ioannidis calls for more rigorous nutrition research | News Center
July 16, 2018 - University of Illinois buys 3D-Bioplotter for regenerative biology, tissue engineering research
July 16, 2018 - Charité’s researchers integrate open-source platform into the ‘Human Brain Project’
July 16, 2018 - SUSU scientists develop rehabilitation device for people with lower limbs injuries
July 16, 2018 - Researchers find definite increase in scooter-related injuries
July 16, 2018 - Researchers solve mystery of final blood group system
July 16, 2018 - Researchers develop near-infrared fluorophores-based PDT to cure cancer with less side effects
July 16, 2018 - Traumatic brain injury biomarker could help predict patient prognosis
July 16, 2018 - Researchers to investigate role of hormones in mosquito’s ability to use human blood for egg production
July 16, 2018 - AHA: Doctor Makes Lifesaving House Call in His Own Home
July 16, 2018 - Nearsightedness – Genetics Home Reference
July 16, 2018 - Study shows biomarker panel boosts lung cancer risk assessment for smokers
July 16, 2018 - Researchers find link between bereavement during pregnancy, child’s mental health | News Center
July 16, 2018 - Legalizing same-sex marriage has meaningful effects on health care access for sexual-minority men
July 16, 2018 - New York to allow medical marijuana as substitute to opioids
July 16, 2018 - Reducing tapeworm infection could improve academic performance, reduce poverty | News Center
July 16, 2018 - Researchers describe key role of enzyme in regulating immune response against Chagas disease parasite
July 16, 2018 - Johnson & Johnson Announces Publication in The Lancet Highlighting Robust Immune Response to Janssen’s Mosaic-based Preventive Vaccine Regimen for HIV
July 16, 2018 - Do Racial and Gender Disparities Exist in Newer Glaucoma Treatments?
July 16, 2018 - Antibodies may predict transplant rejection risk
July 16, 2018 - New center sets out to stop disease before it starts | News Center
July 16, 2018 - FDA warns consumers about criminals sending fake warning letters
July 16, 2018 - Residential segregation linked with racial disparities in firearm homicide fatalities
July 16, 2018 - UW-Madison researchers develop new method to track Parkinson’s damage in the heart
July 16, 2018 - New approach to cultivate hypoallergenic tomato and strawberry varieties
July 16, 2018 - Smoking associated with delayed shinbone healing
July 16, 2018 - Sheila Dolezal, ‘team player extraordinaire,’ wins 2018 Amy J. Blue Award | News Center
July 16, 2018 - Advanced Prostate Cancer Variant More Common Than Thought
July 16, 2018 - New ways to conquer sleep apnea compete for place in bedroom
July 16, 2018 - Renowned microbe hunter Stanley Falkow dies at 84 | News Center
July 15, 2018 - FDA Slaps Stronger Warnings on Potent Class of Antibiotics, Fluoroquinolones
July 15, 2018 - Don’t let depression keep you from exercising
Trump Releases FY 2019 Budget Proposal

Trump Releases FY 2019 Budget Proposal

image_pdfDownload PDFimage_print

WASHINGTON — President Trump’s proposed budget continues the administration’s push to repeal and replace the Affordable Care Act despite waning enthusiasm for repeal among some key lawmakers, who would prefer to move on to other priorities.

The fiscal year 2019 budget proposal also promotes comprehensive Medicaid reform (including a repeal of the Medicaid expansion), strategies for reducing drug prices, increased funding for the opioids crisis, greater investment in veterans’ healthcare, and a potential overhaul of key Department of Health and Human Services (HHS) agencies.

The proposal would reduce the deficit by $3 trillion over a 10-year period, according to documents released by the administration on Sunday.

Healthcare

In total, the president’s budget request includes $68.4 billion for HHS, which is $17.9 billion or 21% less than 2017 enacted levels. The proposal also includes $675 billion in “net mandatory savings across HHS and the Department of the Treasury to repeal and replace Obamacare.”

The document proposes “a two-part approach to repealing and replacing Obamacare, starting with enactment of legislation modeled closely after the Graham-Cassidy-Heller-Johnson (GCHJ) bill as soon as possible, followed by enactment of additional reforms to help set Government healthcare spending on a sustainable fiscal path that leads to higher value spending.”

“The President is also committed to the comprehensive Medicaid reform in the GCHJ bill, including the repeal of the Obamacare Medicaid expansion and reducing State gimmicks, such as provider taxes, that raise Federal costs.”

The proposal supports identifying state-based solutions that “prioritize Medicaid dollars for the most vulnerable” such as work requirements — also known as “community engagement activities” — for certain “able-bodied adults.”

Previous proposals have been criticized for cuts to Medicaid and Medicare, and Mick Mulvaney, director of the Office of Management and Budget, sought in a press call Thursday afternoon to pre-emptively defend against such critiques.

“When we talk about Medicare and talk about Medicaid today … we’re talking about things that lower drug prices and save money for folks who are in these programs. We’re not talking, in a single instance, about denying anybody coverage, raising anybody’s age, [or] doing any means testing.”

For example, the executive budget proposes better defining which drugs Medicaid treats as brand-name products versus generic drugs. Correctly categorizing certain products, such as epipens, as generics would create savings for the program.

Curbing the Opioid Epidemic

In responding to the opioid crisis, the proposal requests $5 billion in new funding for HHS over 5 years, including $1 billion in 2019, to help prevent opioid abuse and to provide overdose-reversal drugs, treatment, recovery, and supports.

If this proposed budget is followed, the Office of National Drug Control Policy would receive more than $7 billion for prevention, treatment, and law enforcement efforts, and the Drug Enforcement Administration (DEA) would see another $2.2 billion.

The budget also endorses a $123 million increase in funding for the Substance Abuse and Mental Health Services Administration for “opioid abuse prevention, treatment, recovery support, and overdose reversal” and requests another $126 million to increase prevention efforts and surveillance by improving Prescription Drug Monitoring Programs.

The proposal also suggests authorizing HHS to work with the DEA to revoke a provider’s certificate to prescribe controlled substances “when that provider is barred from billing Medicare based on a pattern of abusive prescribing.”

Trump’s budget also supports implementing a pilot program at the National Institutes of Health for developing non-addictive pain medications as a subsitute for opioids, Mulvaney noted in the teleconference.

Lowering Drug Prices

The budget proposal also aims to lower drug prices by addressing “perverse payment incentives” and by “exposing drug companies to more aggressive competition,” the document noted.

The proposal looks to achieve lower drug prices by proposing changes that would improve 340B program integrity. (The program provides discounts on drugs for low-income hospitals but critics say it has expanded beyond its intended scope.) The budget proposal suggests revising hospital payments for drugs bought through the program by “rewarding hospitals that provide charity care and reducing payments to hospitals that provide little to no charity care.”

The document also suggests that Medicaid pursue a pilot project allowing five states to establish their own drug formularies and negotiate drug prices directly with drug companies. The approach would also involve establishing an appeals process as a guardrail against beneficiaries losing access to needed drugs.

Regarding the FDA, the budget proposes to increase competition by ensuring that “first-to-file generic applicants,” which have a 180-day exclusivity period, aren’t trying to “unreasonably and indefinitely block subsequent generics from entering the market” past the predetermined exclusivity period.

In addition, the proposal recommends allowing Medicare Part D beneficiaries to share in the rebates manufacturers provide. “At least one-third of those rebates have to be passed on to the purchasers at the point of sale; it’s going to have the impact of lowering the out-of-pocket costs of folks who are on Medicare,” Mulvaney explained.

He also pointed out in a teleconference Monday afternoon, that the executive budget seeks to establish “true out-of-pocket caps” for seniors through the Medicare Part D program, and to limit increases in reimbursement for drugs administered under Medicare Part B.

Veterans’ Healthcare

The new budget proposal suggests directing $83.1 billion for the Department of Veterans Affairs, representing an $8.7 billion, or 11.7%, increase from the 2017 enacted level, the document noted.

“It is our Nation’s duty to ensure veterans have access to the medical treatment they need, when they need it — and that they have a choice when it comes to their care,” wrote President Trump in a letter that preceded the budget document.

The budget would expand the Veterans’ Choice program in an effort to increase access to healthcare and would “implement a modernized appeals system to provide veterans with better medical options,” the document noted.

HHS Redesign

The budget plan also provides a blueprint for “reorganiz[ing] HHS by “improving the management of the Strategic National Stockpile; streamlining the administrative functions at the National Institutes of Health; and improving efficiency through examining the effectiveness of the U.S. Public Health Service Commissioned Corps.”

The blueprint suggests that because the corps does not meet the criteria for the Department of Defense’s military compensation system and because its “mission assignments and functions have not evolved in step with the public health needs of the Nation,” HHS should review how the corps is structured.

A new plan will be announced after a deep analysis, but the administration’s recommendations could range from more minor “phasing out unnecessary Corps functions” to substantial, “reinventing the Corps into a smaller, more targeted cadre focused on providing the most vital public health services and emergency response.”

In addition, the budget suggests shifting the Strategic National Stockpile from the CDC’s purview to HHS’s Assistant Secretary for Preparedness and Response.

The proposal also suggests consolidating the research of three entities — the Agency for Healthcare Research and Quality; the National Institute for Occupational Safety and Health; and the National Institute on Disability, Independent Living, and Rehabilitation.

Big Picture

On Friday, Congress passed a stopgap spending bill to keep the government open for roughly 6 more weeks.

In addition to boosting defense spending, that bill included billions in funding for the opioid crisis, community health centers, and disaster relief, and extended the Children’s Health Insurance Program for 10 years, but it also blew through predetermined spending caps, increasing spending by somewhere between $300 billion and $500 billion over the next 2 years, depending on various estimates.

On Friday, policy experts shared their expectations of the budget proposal, with some calling it “irrelevant” given that the spending bill had already passed.

When asked about the projected deficit increases from Congress’s recently passed spend bill, Mick Mulvaney, director of the Office of Management and Budget, speaking on Fox News on Sunday, argued that the president’s proposal could undo that damage.

“The budget does bend the trajectory down, it does move us back towards balancing. It does get us away from trillion dollar deficits. Just because this deal was signed does not mean the future is written in stone,” he said.

1969-12-31T19:00:00-0500

last updated

Tagged with:

About author

Related Articles