President Barack Obama’s 2016 budget calls for extending the Medicaid pay bump for primary care physicians, improving access to health providers, and installing a permanent fix to Medicare’s Sustainable Growth Rate reimbursement formula.
The president outlined his nearly $4 trillion budget in a summary released Feb. 2 by the White House. The proposal includes extending increased payments for primary care services delivered by physicians who accept Medicaid through 2016, with modifications to expand provider eligibility. The president also wants to enhance training of primary care practitioners and other physicians in high-need specialties by providing $5.25 billion over 10 years to support 13,000 new medical school graduate residents through a new graduate medical education program.
In addition, the president is seeking the end of sequestration, the broad federal cuts triggered by the Budget Control Act of 2011. During a Feb. 2 news conference, the president stressed that the deficit reduction achieved during his presidency – a reported cut of two-thirds – makes his budget proposals possible.
President Barack Obama
“We can afford to make these investments, while remaining fiscally responsible,” President Obama said during the conference. “In fact, we would be making a critical error if we avoided making these investments.”
The president’s budget includes a number of recommendations that would cut billions in Medicare funding over the next 10 years.
The budget would reduce the projected growth of Medicare payments for graduate medical education by $16 billion, while saving more than $100 billion by reducing inflation updates for providers who treat Medicare beneficiaries after they leave the hospital. Meanwhile, improving payment accuracy for the Medicare Advantage program would result in $43 billion in savings over 10 years, according to the plan.
The proposal also seeks to extend funding for the Children’s Health Insurance Program (CHIP) through 2019 and give states the option to streamline eligibility determinations for children in Medicaid and CHIP.
The president said he wants to accelerate physician participation in high-quality and efficient health care delivery systems by repealing the SGR and reforming Medicare physician payments consistent with recent bipartisan legislation. Obama also suggested extending increased Medicaid payments to primary care physicians through 2016 at a cost of $6.3 billion.
Other medical and public health care proposals include:
• Directing more than $100 million to reduce abuse of prescription opioids and $4.2 billion to the Health Center Program to expand services to an additional 1 million patients.
• Funding increases for every state to expand existing prescription drug monitoring programs, and funding increases for the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, and the Agency for Healthcare Research and Quality to decrease the rates of inappropriate prescription drug abuse.
• An increase of more than $550 million above 2015 enacted levels across the federal government to prevent, detect, and control illness and death related to infections caused by antibiotic-resistant bacteria.
• More than $500 million to enhance the advanced development of next-generation medical countermeasures against chemical, biologic, radiologic, and nuclear threats.
• A 6% spending increase in medical research and development to fuel programs such as the Precision Medicine Initiative and the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative.
• Increased access to generic drugs by stopping companies from entering into anticompetitive deals intended to block consumer access to generics.
The administration contends the budget will trim the deficit by $1.8 trillion over the next decade, primarily because of health, tax, and immigration reforms. That includes $400 billion in health savings that would grow over time – raising about $1 trillion in the second decade and extending the Medicare hospital insurance trust fund solvency by about 5 years, the president said.
Republican lawmakers criticized the budget proposal, calling it a repeat of past failures.
“Today President Obama laid out a plan for more taxes, more spending, and more of the Washington gridlock that has failed middle-class families,” House Speaker John Boehner (R-Ohio) said in a statement. “It may be Groundhog Day, but the American people can’t afford a repeat of the same old top-down policies of the past. Like the president’s previous budgets, this plan never balances – ever.”
Liberal groups, such as the Center for American Progress, praised the budget proposal.
“President Obama’s budget lays out a detailed agenda to create good jobs, raise wages, and help working families achieve middle-class security,” Carmel Martin, the center’s executive vice president, said in a statement. “Rather than stumbling through a series of unnecessary manufactured crises or clinging to failed austerity measures such as sequestration, Congress has an opportunity to work with President Obama to build an economy that works for everyone, not just the wealthy few.”