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Trump Budget - $616B Proposed Medicaid Cut Jeopardizes Home Health

Tuesday, June 6, 2017   (0 Comments)
Posted by: Mandy Rubenstein
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President Donald Trump unveiled his budget proposal for 2018, which included significant cuts to Medicaid and the Children’s Health Insurance Program (CHIP). (READ MORE) The proposed cuts would total $616 billion from Medicaid and the Children’s Health Insurance Program over the next decade, and there are other provisions in the budget that could impact the home health industry.

“What is offered is a combination of good news and bad news,” Bill Dombi, vice president for law at the National Association for Home Care and Hospice (NAHC), told Home Health Care News.

The Bad:
• Drastic Medicaid cuts, on top of the roughly $800B in cuts outlined in the American Health Care Act (AHCA)
• Gives states the choice between a block grant or per capita caps for receiving federal dollars in the program
• Lacks details on spending cuts
• Community First Choice benefit could be eliminated

“Our largest concern as providers in the Medicaid services space is that this is $610 billion in cuts on top of any AHCA cuts,” Joy Cameron, vice president of policy and innovation at ElevatingHome, “Significant seems like such a little word to described the magnitude of these cuts. …This puts the ability of patients to get high quality service in their homes in serious risk.”

“We are very concerned that the decades-long battle to provide Medicaid beneficiaries with improved access to home care rather than institutional care will risk a serious setback through these changes,” Dombi said. “States can still fund home and community based care, but it will be harder.”

The Partnership for Medicaid Home-Based Care (PMHC) responded to the budget by urging Congress to push for home-based care services and incentivize this option over nursing homes.

“By strengthening Medicaid recipients’ access to high-quality, low-cost, consumer-preferred home- and community-based services, we are confident that decision makers can achieve improved outcomes, increased quality of life and satisfaction and significantly reduce program costs,” PMHC Chairman David J. Totaro said in a statement.

The Good:
• Does not include direct cuts to Medicare in 2018
• Includes a proposal to repeal the Independent Payment Advisory Board, which is responsible for recommending Medicare spending within legislated limits to Congress.
• Adds $127 million annually to help reduce the Medicare appeals backlog

Ultimately, the President’s budget proposal is just that—merely a proposal. Congress is charged with the authority to create and affirm federal spending, and it is not unusual for a final budget to bear little resemblance to the White House’s initial proposal.


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