A copy of President Trump’s budget for fiscal 2018 was accidentally posted to the Department of Health and Human Services website Monday, revealing details of the proposal a day before it was scheduled to be released to the public.
“The only official version of the HHS budget will be released by the Office of Management and Budget at 11 a.m. tomorrow,” Alleigh Marré, spokeswoman for the agency, said in an email. “At that time, Budget Director Mulvaney will hold a press briefing and address any questions.”
A president’s budget reflects the priorities of the administration, with final decisions on spending made by Congress. Here are six highlights, according to the version posted, from the various agencies and programs Health and Human Services represents:
1. It takes into account the assumption that Republicans will be successful in passing a bill to repeal and replace Obamacare.
The budget proposal projects that through repealing and replacing Obamacare, the federal government would save a net $250 billion over a decade. The wording suggests that people would face additional requirements for qualifying for Medicaid and that a new healthcare law would offer tax credits for purchasing insurance as well as incentives for health savings accounts. While it says that the department would provide funding for states to stabilize markets, it doesn’t specify whether that would be through funding cost-sharing reduction subsidies or through reinsurance programs or other means.
2. It makes additional cuts to Medicaid.
The proposal projects that the federal government would save $665 billion over a decade once it begins allowing states to change the way their Medicaid programs are structured, whether by switching to a per-capita cap or a block grant in 2020. These changes would allow Medicaid dollars to be spent the way states choose, but critics say they would result in fewer people receiving care. Medicaid is already projected to lose $880 billion under Obamacare repeal, according to earlier estimates of the bill.
3. It funds opioid treatment.
The proposed budget allocated $500 billion for treatment, including through the use of medication, as well as $1.9 billion in block grants for states to address substance abuse. The Substance Abuse and Mental Health Services Administration also would receive $25 million to address such programs and an additional $24 million to fund opioid-reversal drugs.
4. It creates a block grant to combat childhood obesity.
The grant, which would total $500 million, would fund state-led programs that promote better nutrition and more exercise.
5. It makes cuts to rural health.
Hospital Flexibility Grants and State Offices of Rural Health would be discontinued, and funding instead would continue to go toward the Rural Health Outreach Network and Quality Improvement Grants, Rural Health Policy Development, Black Lung Clinics and Telehealth. The total fund would be $74 million, which is $75 million below the 2017 continuing resolution.
6. It cuts from the Centers for Disease Control and Prevention and the National Institutes of Health.
The CDC could be cut by nearly $1 billion. Its programs inform the public, track diseases and enact prevention efforts, and programs that cover HIV, disabilities, environmental health and injury prevention were among the initiatives that facing cuts. The budget would cut NIH, the agency that funds medical research, by $5.7 billion, in part by eliminating the Fogarty International Center.
