Last week, the Trump Administration released its fiscal year (FY) 2020 budget blueprint, “A Budget for a Better America: Promises Kept. Taxpayers First.” Its multitude of dangerous proposals demonstrates the size and severity of possible Federal funding cuts that New York State faces. While parts of this non-binding proposal will be dismissed outright, it still offers insight into the White House’s legislative and regulatory goals for the coming year. GNYHA will work vigorously with our allies on Capitol Hill to oppose any dangerous, misguided cuts in health care funding and will tell New York State lawmakers that these Federal funding threats bolster the need for increased health care funding on the State level.
The budget blueprint includes dangerous proposed policies that would:
- Double down on Medicaid disproportionate share hospital (DSH) cuts by leaving FY 2020 cuts in place and extending DSH cuts for four additional years through FY 2029: a $25.9 billion cut over 10 years
- Consolidate graduate medical education (GME) funding from Medicare, Medicaid, and the Children’s Hospital GME program into a single grant program: a $48 billion cut over 10 years
- Enact a “site-neutral” payment cut to hospital outpatient departments (HOPDs) that would cap payments for outpatient services provided in off-campus locations: a $27.8 billion cut over 10 years
- Enact an additional site-neutral cut to HOPDs that would cap payments for outpatient services provided in on-campus settings: a $131.4 billion cut over 10 years
- Base distributions in Medicare uncompensated care pool funding on bad debt and charity care data (S-10 data), and cap the pool’s rate of growth, among other provisions: a $98 billion cut over 10 years
- Reduce Medicare bad debt payments from 65% generally to 25% for all eligible providers over three years: a $38.5 billion cut over 10 years
- Repeal the Affordable Care Act and replace it with block grants for the marketplaces and Medicaid: an $800 billion cut over 10 years
- Alter the Centers for Medicare & Medicaid Services’ 2018 cuts to 340B drug discount program hospitals, implement a 340B “user fee,” and enact 340B program transparency and accountability
- Change Medicare reimbursement for post-acute care: a $101 billion cut over 10 years