President Trump has submitted to Congress his budget request for fiscal year 2020. The budget request, which is not binding, proposes hundreds of billions of dollars in reductions to Medicare and Medicaid over 10 years. The budget request also contains a number of provisions related to drug pricing, opioids and other health-related issues. The proposed cuts raise serious concerns about how hospitals and health systems can ensure they serve as the safety net for their patients.
The White House budget includes cuts to Medicare for care in hospital outpatient departments, teaching hospitals for medical education, post-acute providers, assistance that helps to defray some of the costs of caring for low-income seniors and cuts to the Medicaid program by redesigning it through block grants or per capita caps. Fixed income retirees need a stable, reliable Medicare benefit and access to hospitals, which this budget would jeopardize.
The proposed cuts to hospital outpatient department care fail to recognize the crucial role hospitals serve for their communities and the very different clinical capabilities, such as access to all and 24/7 emergency services. In addition, this could stifle hospitals’ ability to modernize care to meet the needs of patients and communities.
The budget blueprint does not spare either teaching hospitals or post-acute providers – both of which play key roles in ensuring access to care. Teaching hospitals provide around-the-clock services not available anywhere else and train future physicians who will care for our nation’s seniors. And there are cuts for the specialized services provided by post-acute care providers.
In addition, this proposal contains troubling reductions in assistance to hospitals and health systems that help defray some of the costs of caring for low-income seniors. Unfortunately, this budget proposal threatens the important safeguard that Medicaid offers for millions of Americans, including the elderly, disabled and low-income individuals, who rely on the program for their health care needs.
Most concerning is proposed Medicaid restructuring being used as a vehicle to make cuts to this vital program. Redesigning Medicaid, such as through block grants or per capita caps, could lead to substantial changes in benefits and payments and reduce access to care for patients.
All patients should be confident as they count on their hospital to be their lifeline to access care in their community. And all communities should be able to look to their hospitals as stable hubs for both health care and economic growth. Funding cuts proposed in the White House budget undermine that confidence as they threaten the viability of hospital care.