WASHINGTON — President Trump's 2019 budget released Monday proposes cutting $1.7 trillion in funding from Department of Health and Human Services' (HHS) programs, including Medicare, over a decade, while boosting funding to combat the opioid epidemic and high drug prices.
Trump also urged Congress to repeal the Affordable Care Act (ACA) and, in effect, slash Medicaid by passing an ACA replacement bill.
The administration also requested $5 billion in new HHS funding over the next five years to combat the opioid epidemic.
Advocacy groups were quick to oppose the budget proposal, which is an outline of the administration's goals that is expected to face political opposition from both parties on Capitol Hill.
"As a deadly flu epidemic continues to sicken people across America, President Trump’s budget today shows that he remains worse than indifferent to our health care," said Brad Woodhouse, executive director of the Protect Our Care Campaign, a coalition of groups that supports the ACA. "Enough is enough: the sabotage, cuts, and repeal attempts must stop. Congress should declare this budget’s anti-health care proposals dead on arrival.”
The administration did signal its support for more attention to the opioid epidemic and drug costs, however. HHS Secretary Alex Azar said the two issues, coupled with making insurance more affordable and improving Medicare so it pays more for quality than the quantity of services provided, demonstrate the administration's priorities.
The budget "reflects a solemn and unshakable commitment to liberate communities from the scourge of opioids and drug addiction, the White House budget statement said.
The budget proposed new strategies to address high drug prices by targeting areas including what it called "perverse payment incentives," that reward the use of higher costs drugs.
Under the budget, up to five states could participate in pilot projects to test drug coverage and financing reforms based on "best practices" at commercial insurers. These states could negotiate drug prices directly with manufacturers and set up their own drug formularies with an appeals process that would help patients get drugs that are medically necessary.
Despite the high-profile attention drug prices are getting, Patients for Affordable Drugs founder David Mitchell criticized the budget's failure to "lay a glove on Big Pharma."
“The President has correctly stated the problem: Big drug corporations are getting away with murder," says Mitchell. "Yet there is nothing in the budget proposal to address that fact."
Mitchell, who has an incurable blood cancer that requires some of the costliest drugs sold, says he hopes to get more detail and to work with the administration on solutions. A "better blueprint," he says, would be the November 2017 National Academy of Sciences' report that prioritizes Medicare bargaining and reforms to stop drug company patent abuses.
How other health programs would fare:
• The food stamp program, known as Supplemental Nutrition Assistance Program, would be cut by more than $200 billion over 10 years.
• The National Institutes of Health would get $100 million for a public-private partnership with the pharmaceutical industry to develop prevention and treatments for addiction, overdose-reversal, and non-addictive therapies for pain.
• As part of the $1 billion increase, HHS' Substance Abuse and Mental Health Services Administration would receive $123 million for opioid abuse prevention, treatment, recovery support, and overdose reversal.
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