Trump Targets Medicaid, Medicare in Budget

A significant slowdown in Medicaid spending and a large reduction in Medicare are among the health-related cuts proposed in the budget released Monday by the Trump administration.

It calls for Medicaid to change from an entitlement program to state block grants, something previously rejected by a Republican Congress, the Washington Post reported.

The proposal calls for a cut of nearly $1.5 trillion in Medicaid over 10 years and for $1.2 trillion to be added for the block grants or per-person caps that would start in 2021. Under the grants program, states would gain far more freedom to set their own rules about how to cover health care for the poor, according to the Post.

The budget also would eliminate funding for Medicaid expansion under the Affordable Care Act, which has gone to about three dozen states over the past five years.

As for Medicare, the proposed spending reductions focus on changing payments to doctors and hospitals and renewing efforts to reduce fraud and wasteful billing, the newspaper reported.

The White House budget also follows up on Trump's pledge in last month's State of the Union address to halt the spread of HIV in the United States over the next decade.

An initial $291 million is included next year for communities where the HIV continues to infect people not getting proper treatment. That includes rural areas of seven states, including Mississippi; the District of Columbia; Puerto Rico and 48 hot-spot counties nationwide, the Post reported.

However, the budget would reduce funding for global AIDS programs and cut spending on the U.S. Centers for Disease Control and Prevention by about 10 percent.

Spending on the National Institutes of Health would be reduced by $4.5 billion, with the largest part of the cut affecting the National Cancer Institute. However, funding for childhood cancer research would be boosted by $50 million in the next fiscal year, the Post reported.

Also included in the budget are strategies to control rising prescription drug prices.

Altogether, the Trump budget's $87.1 billion in discretionary funding for U.S. Health and Human Services programs would be 12 percent less than in the spending plan Congress adopted for this fiscal year, the Post reported.

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