Budget

The Trump administration budget banks $250 billion in net deficit savings over 10 years on the assumption that Congress will repeal and replace the Affordable Care Act, according to HHS budget documents posted briefly on Monday prior to their official release.

President Donald Trump's fiscal 2018 budget proposes cutting FDA's discretionary budget authority by $854 million -- a shortfall that Trump says would be made up if lawmakers agree to his request to double user fees, despite the fact lawmakers on both sides of the aisle have to date rejected that proposal.

Lawmakers, government officials and advocacy groups are warning cuts to HHS, FDA and the National Institutes of Health could severely damage public health and medical research as they brace for President Donald Trump's full fiscal 2018 budget request to be released later this month.

Key House Republicans are signaling they may push additional Medicaid cuts and Medicare reforms as part of the 2018 budget.

The congressional government-spending agreement guarantees the Trump administration would be in control of Medicare cuts if the Independent Payment Advisory Board is triggered this year because the spending deal defunds IPAB.

Along with the release of a fiscal 2017 spending deal Monday (May 1), lawmakers released explanatory language weighing in on several CMS issues, including calling for a full audit of air emergency transport, mitigation of the reduced rates for critical access hospitals, and a loosening of agency policy on hospitals that didn't get their fair share of incentive payments through the Medicare Electronic Health Records Incentive Program.

Congress passed a continuing resolution Friday (April 28) to fund the government another week, and the two parties continue to debate how to tackle the Affordable Care Act's cost-sharing reductions as part of an omnibus spending bill to fund the government the rest of the fiscal year.

With the federal government facing a shutdown in just two days unless Congress passes a spending bill, Democrats on Wednesday appeared to be coalescing behind House Speaker Nancy Pelosi's (D-CA) push for inclusion of the Affordable Care Act’s cost-sharing reduction payments and a provision to clarify they are mandatory in the omnibus spending bill while House Speaker Paul Ryan (R-WI) held the line Wednesday (April 26) that Republicans would not appropriate the payments.

The White House Office of Management and Budget met with federal agencies Friday to prepare for a possible government shutdown should Congress doesn't pass a new spending bill when the Continuing Resolution runs out April 28, but HHS' prior contingency plan shows that many of CMS' functions would continue using mandatory funding.