Thursday, 21 March, 2019

Trump's cuts to Medicare hospital payments brings outcry

US president donald trump Outcry over Trump's cuts to Medicare hospital payments
Ben Pena | 14 March, 2019, 21:55

President Donald Trump unveiled his third budget resolution on March 11, titled "A Budget for a Better America: Promises Kept". The analysis from the Committee for a Responsible Federal Budget (CRFB) finds that the vast majority of the Medicare cuts in Trump's budget, released on Monday, are to payments to hospitals and doctors, not cuts to benefits for seniors on the program.

"Hospitals are less and less able to cover the cost of care for Medicare patients", FAH president and CEO Chip Kahn said in a statement.

It cuts $845 billion, nearly a trillion dollar cut in Medicare, and nearly a quarter trillion, $240 billion cut in Medicaid. Why?

In 2017, when Republicans still controlled both chambers of Congress, as well as the White House, they pushed through deep tax cuts, mainly for businesses, that were projected to add $1.5 trillion to the $20 trillion national debt over 10 years. It would have capped federal spending on the entire program and left millions of people uninsured.

The rhetoric harkens back to earlier this decade when Republicans lashed out at former President Barack Obama for including similar provider payment cuts in the Affordable Care Act, saying that he was hurting the elderly. But the budget also serves as a menu of longtime Republican visions for the program, including repealing Medicaid expansion and Obamacare subsidies and giving states a fixed sum of money, known as a block grant, instead. The Republican lawmaker cited a report from the Congressional Budget Office that the public debt is expected to reach 78 percent of gross domestic product this year.

With Brexit deal down, United Kingdom lawmakers have 2 more choices
Sterling rose on news of the deal but then gave up its gains by mid-morning and was trading $1.3163 at 1040 GMT. "Let's be crystal clear about the choice: it is this deal or Brexit might not happen at all", he said.

The wide-ranging proposal, which revives the president's push to build a U.S. -Mexico border wall, seeks to increase defense spending to $750 billion - including a new Space Force in the military branch - and to reduce non-defense accounts by 5 percent, according to the Associated Press.

Galdieri said the White House "still does not seem to have internalized the fact that they did so badly in the 2018 midterms and that the Democrats now have a major role in the budget".

"These cuts in the Trump budget aren't a tightening of the belt or a trimming of the fat, or even a serious attempt at reining in spending", House Budget Committee Chairman John Yarmuth (D-Ky.) said during the hearing. It also wants to slow the growth of payments for skilled nursing, inpatient rehab facilities and home health services, said Tricia Neuman, director, Program on Medicare Policy at the Kaiser Family Foundation. However, some of the reduction is from shifting Disproportionate Share Hospital and Graduate Medical Education programs from Medicare to other parts of the HHS budget.

Advocates for Medicare beneficiaries had a measured reaction.

The budget proposal "practices the Robin Hood principle in reverse", said Senator Bernie Sanders, budget panel member and 2020 Democratic presidential candidate. "But we must also think about how we can help families to access financial programs, educational opportunities, and higher paying jobs".

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