Breaking News
September 26, 2018 - Epidural stimulation and locomotor training helps patients with spinal cord injury to walk
September 26, 2018 - RTI’s TETRAfuse 3D Technology wins 2018 Spine Technology Award
September 26, 2018 - Researchers discover novel targeting agents to prevent cancer metastasis
September 26, 2018 - Researchers develop molecule that makes cancer cells sensitive to radiotherapy
September 26, 2018 - American Cancer Society releases new cookbook for cancer patients
September 26, 2018 - Relmada Therapeutics Provides Enrollment Update in Phase 2 Study of REL-1017 (dextromethadone) in Patients with Major Depressive Disorder
September 26, 2018 - Many doctors in India miss TB signs: study
September 26, 2018 - Horwitz Prize Awarded for Work on Hormones
September 26, 2018 - Genomic ‘islands’ evolved from viruses can be converted into ‘anti-bacterial drones’
September 26, 2018 - Most running injuries may be influenced by simple technique errors, finds study
September 26, 2018 - Optimizing dopaminergic treatment improves non-motor symptoms and quality of life
September 26, 2018 - NIRS-IVUS imaging identifies patients and plaques vulnerable to subsequent adverse cardiac events
September 26, 2018 - New insights into what drives organ transplant rejection
September 26, 2018 - Tiny Device Is a ‘Huge Advance’ for Treatment of Severe Heart Failure
September 26, 2018 - Research shows possibility to postpone cumbersome treatment for low-risk MDS patients
September 26, 2018 - CSU chemists may help in making extracorporeal life support devices more effective
September 26, 2018 - Brain marker linked with aggression in toddlers identified
September 26, 2018 - Blood-brain barrier can be important biomarker for early diagnosis of Alzheimer’s disease
September 26, 2018 - PCORI, AHRQ announce awards to support patient-centered outcomes research in learning health systems
September 26, 2018 - Scientists discover and characterize human skeletal stem cells
September 26, 2018 - Repeat CT Common in Peds Traumatic Epidural Hematoma
September 26, 2018 - Genetics Home Reference: bunion
September 26, 2018 - Increase observed in hearts from drug-intoxicated donors
September 26, 2018 - For Heart Failure Patients, Mitral Valve Procedure Improved Outcomes
September 26, 2018 - TINY cancer detection device shows promise as point-of-care detector of KSHV
September 26, 2018 - Women with non-small cell lung cancers live longer than their male counterparts
September 26, 2018 - KTU researchers engineer experimental bone to help treat osteoarthritis patients
September 26, 2018 - Foundation for a Smoke-Free World calls for proposals to implement Smoke-Free Index
September 26, 2018 - Functional Imagery Training helps lose five times more weight than talking therapy
September 26, 2018 - Fewer American Teens Having Sex, Most Using Birth Control
September 26, 2018 - We are predisposed to forgive, new research suggests
September 26, 2018 - Insomnia Exacts Heavy Toll on Quality of Life
September 26, 2018 - Clinical study shows efficacy, safety of novel drug-eluting stent with improved radiographic visibility
September 26, 2018 - Cytox, AIBL announce expanded agreement to assess genetic risk for Alzheimer’s
September 26, 2018 - Study finds persistent rate of lawnmower injury-related emergency department visits
September 26, 2018 - Researchers find molecule that halts, reverts neurodegeneration caused by Parkinson’s disease
September 26, 2018 - Novartis announces winners of 2018 eXcellence in Ophthalmology Vision Award
September 26, 2018 - New spinout company to tackle drug-resistant infections with novel antibiotics
September 26, 2018 - In depression the brain region for stress control is larger
September 26, 2018 - Smuggling RNA into cells can activate the immune system to fight cancer
September 26, 2018 - Special Focus Issue takes wide view of complementary and integrative medicine in cancer
September 26, 2018 - Researchers now confirm that genome duplication drives evolution of species
September 25, 2018 - Study provides evidence of beta lactamase producing, antimicrobial resistant E. coli in U.S. retail meat
September 25, 2018 - UCI study finds new cause of cerebral microbleeds
September 25, 2018 - Researchers propose mechanism by which ASTN2 protein defects lead to brain disorders
September 25, 2018 - Chinese and German researchers to cooperate more closely in future for better food
September 25, 2018 - Recent study helps predict probability of pregnant mothers to have child with autism
September 25, 2018 - New online, sound matching tool offers tinnitus sufferers potential treatment options
September 25, 2018 - UC Davis researchers take critical step in developing more effective Salmonella vaccine
September 25, 2018 - Antibiotics best paediatric treatment for children’s chronic wet cough
September 25, 2018 - Looking beyond opioids: Stanford pain psychologist briefs Congress
September 25, 2018 - Organs actively fighting back against autoimmune diseases, finds study
September 25, 2018 - Lancaster professor aims to understand how genes affect smoking cessation
September 25, 2018 - Human-oriented perspective needed to better understand Parkinson’s disease
September 25, 2018 - Physical activity may have beneficial effects for people with rare Alzheimer’s disease
September 25, 2018 - FDA Updates on Valsartan Recalls
September 25, 2018 - 3-D-printed tracheal splints used in groundbreaking pediatric surgery
September 25, 2018 - Who is the designated driver, or proxy, for your health decisions?
September 25, 2018 - New chemo-optogenetic method enables multi-directional activity control of cellular processes
September 25, 2018 - Study explores link between genetic predisposition to Alzheimer’s and cardiometabolic risk factors
September 25, 2018 - NeoTract presents new clinical data from studies of UroLift System for patients with BPH
September 25, 2018 - Patients with paralysis manage to walk thanks to new technology
September 25, 2018 - Statins Improve Long-Term Survival After AAA Repair
September 25, 2018 - Novel brain network linked to chronic pain in Parkinson’s disease
September 25, 2018 - Researchers reassess negative pressure wound therapy as its benefit and harm remain unclear
September 25, 2018 - Older adults with ‘fall plan of care’ less likely to suffer fall-related hospitalizations
September 25, 2018 - FDA lifts partial clinical hold that paused enrollment of new patients in tazemetosta clinical trials
September 25, 2018 - IME Medical Electrospinning establishes state-of-the-art manufacturing lab facilities
September 25, 2018 - Phase 1 and 2 clinical trials of entrectinib drug in ROS1-positive NSCLC show promising results
September 25, 2018 - How to Protect Your Eyesight
September 25, 2018 - Novel approach allows researchers to define how cells in the retina respond to diabetes
September 25, 2018 - Columbia University announces winners of 2018 Louisa Gross Horwitz Prize
September 25, 2018 - New model enables anyone to run powerful simulations, complex calculations easily
September 25, 2018 - Clinical trial investigators found non-compliant with requirement to report results on EU register
September 25, 2018 - Study analyzes quality of protein supplements in function of source, treatment and storage
September 25, 2018 - FDA grants Orphan Drug Designation to Myelo001 for treatment of Acute Radiation Syndrome
September 25, 2018 - U.S. Alzheimer’s Cases to Nearly Triple by 2060
September 25, 2018 - Improving cell replacement therapy for Parkinson’s disease
September 25, 2018 - Genervon reports new findings that drug candidate GM6 attenuates Alzheimer’s disease in mice model
September 25, 2018 - FDA approves new 5 mm diameter drug-eluting stent from Cook Medical
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