Breaking News
April 20, 2018 - Metabolic Syndrome Common With Chronic Hep B Infection
April 20, 2018 - Tracking quality of life during prostate cancer treatment
April 20, 2018 - Study shows presence of beta-amyloid dimers in the brains of Alzheimer’s patients
April 20, 2018 - Researchers identify link between physical inactivity and increased risk of dying from cancer
April 20, 2018 - Breathtaking evolution amongst Indonesian tribe
April 20, 2018 - Study shows testosterone deficiency in men is associated with chronic diseases
April 20, 2018 - Simple one-page form helps improve satisfaction of patients with care
April 20, 2018 - Researchers evaluate accuracy of simple blood test to predict lung cancer
April 20, 2018 - Study looks at sperm producing ability in testicular cancer patients
April 20, 2018 - Exercise In, Vitamin D Out for Preventing Falls: U.S. Panel
April 20, 2018 - Skin cancers associated with decreased risk of developing AD
April 20, 2018 - Preserving fertility during chemotherapy
April 20, 2018 - Teva and Procter & Gamble Company terminate PGT Healthcare partnership
April 20, 2018 - People diagnosed with traumatic brain injury may have increased risk of Parkinson’s disease, shows study
April 20, 2018 - Researchers use smartphone to diagnose people infected with Loa loa worm
April 20, 2018 - College students with autism have high rate of suicidal thoughts
April 20, 2018 - Study sheds light on how the HSC niche is maintained
April 20, 2018 - Drug test spurs frank talk between hypertension patients and doctors
April 19, 2018 - Low-cost deworming drug improves female farmers’ physical fitness
April 19, 2018 - Genome editing identifies neural circuit behind leptin’s anti-obesity and anti-diabetes effects
April 19, 2018 - Many European countries lack comprehensive policy to eliminate viral hepatitis
April 19, 2018 - Young people with ADHD ‘more likely’ to come from deprived neighbourhoods
April 19, 2018 - SLU professor discovers new biomarkers for chlorine gas exposure
April 19, 2018 - Study proposes new mechanism that may contribute to gender differences in weight control
April 19, 2018 - Sleep restriction therapy does not interfere with insomnia patient’s driving ability, research shows
April 19, 2018 - Deep brain stimulation offers relief to UTHealth patient with treatment-resistant depression
April 19, 2018 - Study shows fatty fish and camelina oil boost HDL and IDL cholesterol
April 19, 2018 - FDA Alert: Euphoric Capsules by Epic Products: Recall
April 19, 2018 - Researchers identify peptide produced during cartilage deterioration as a potential source of osteoarthritis pain
April 19, 2018 - New breakthrough may allow scientists to orchestrate tissue regeneration in humans
April 19, 2018 - SYGNIS AG introduces new TruePrime apoptotic cell free DNA amplification kit
April 19, 2018 - Innovative device shows promise in capturing and releasing circulating tumor cells
April 19, 2018 - Researchers shed light on role of striosomal neurons in reinforcement learning
April 19, 2018 - Genetic make-up impacts long-term effectiveness of phobia treatment
April 19, 2018 - Novel biomarker can distinguish malignant lung nodules
April 19, 2018 - Study reports promising novel approach to treat therapy resistant pediatric brain tumors
April 19, 2018 - One-Hour Plasma Glucose Useful Predictor of Diabetic Retinopathy
April 19, 2018 - Hydroxychloroquine no more effective than placebo for relieving osteoarthritis hand pain
April 19, 2018 - Transplanted livers have a protective effect and reduce potential for organ rejection
April 19, 2018 - Researchers develop new method to study activity of inflammatory cells
April 19, 2018 - Researchers discover highly antibiotic resistant superbugs in Gulf States
April 19, 2018 - Smart-tooth technology shows promise in detecting certain diseases in high-risk patients
April 19, 2018 - Interaction between dioxin and HLA gene variant activates events associated with rheumatoid arthritis
April 19, 2018 - Eyes of adolescents could be associated with increased risk of cardiovascular disease in later life
April 19, 2018 - U.S. Women Less Likely Than Men to Get Statins After Heart Attack
April 19, 2018 - Health Canada grants cannabis cultivation license to High Park Farms
April 19, 2018 - Atypical brain development observed in preschoolers with ADHD symptoms
April 19, 2018 - SC Johnson releases annual Sustainability Report
April 19, 2018 - Positive attitudes about aging reduce risk of dementia in older adults
April 19, 2018 - Environmental pollutants found to worsen rheumatoid arthritis
April 19, 2018 - UT Southwestern scientists discover protein linked to metastatic breast cancer
April 19, 2018 - Study highlights need for further evidence to improve symptom management in end of life care
April 19, 2018 - Detecting diminished dopamine-firing cells inside brain could reveal earliest signs of Alzheimer’s
April 19, 2018 - Uniqsis offers high-power LED light unit for scalable flow photochemistry reactions
April 19, 2018 - Case study shows how intravascular ultrasound imaging helps detect acute aortic syndrome
April 19, 2018 - Research reveals new mechanism by which HIV evades the immune system
April 19, 2018 - Nanodisc-delivered cancer treatment helps eliminate tumors
April 19, 2018 - Functional connectivity MRI could help detect brain disorders and diseases
April 19, 2018 - Finding better way to quantify neuropathy symptoms and treatment efficacy
April 19, 2018 - Study examines effectiveness of caregiver education about sickle cell trait
April 19, 2018 - High-resolution images of tumor vasculature using new technology
April 19, 2018 - Lack of sleep may be linked to risk factor for Alzheimer’s disease
April 19, 2018 - Study finds neurotransmitter may play a role in alcohol relapse, addiction
April 19, 2018 - Researchers build molecular networks of calcific aortic valve disease
April 19, 2018 - Researchers develop highly specific apoptosis assay for pharmacodynamic analyses of tumor specimens
April 19, 2018 - Scientists decipher mechanism of chemotherapy induced female infertility
April 19, 2018 - New insight may allow researchers to design drugs that improve immune responses to vaccines
April 19, 2018 - FDA Approves Crysvita (burosumab-twza) for X-Linked Hypophosphatemia
April 19, 2018 - Researchers uncover origin of virus-fighting plasma B cells
April 19, 2018 - Study finds no evidence of lower intelligence in young children who had anesthesia
April 19, 2018 - Baboons break out of research facility briefly
April 19, 2018 - Study shows how deployment time increases risk of suicide attempt in soldiers
April 19, 2018 - Specific odors from malaria infected individuals attract more mosquitoes
April 19, 2018 - FDA Alert: Rhino 69 Extreme 50000 by AMA Wholesale: Recall
April 19, 2018 - Top HIV cure research team refutes major recent results on how to identify HIV persistence
April 19, 2018 - Experts propose new solutions to increase benefit, affordability of targeted cancer medicines
April 19, 2018 - Deficiency of innate immune adaptor TRIF shortens survival time of ALS mice
April 19, 2018 - New machine learning method offers better way to detect heart disease
April 19, 2018 - CNIO researchers determine structure of protein complex related to cell survival
April 19, 2018 - Faith-based diabetes support program launched by UTSA research team
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