Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


White House Releases FY 2018 Budget Proposal

President Trump released his proposed budget for scal year (FY) 2018 last week. The proposal includes $1.5 trillion in nondefense discretionary spending cuts, and would balance the budget within a decade. While the White House budget would drastically reshape federal spending on anti-poverty and safety net programs, it leaves the Medicare program untouched. The budget assumes that repeal and replacement of the A ordable Care Act (ACA) will be accomplished, resulting in estimated savings of $250 billion over the next ten years. The budget features deep cuts to the U.S. Department of Health and Human Service (HHS) – totaling a reduction of $12.4 billion in discretionary funding.

  • Funding for the National Institutes of Health (NIH) would be reduced by nearly 20 percent, or $6 billion.
  • The budget proposes to decrease spending at the Centers for Disease Control and Prevention (CDC) by $1.3 billion, or 17 percent.
  • The budget proposal would consolidate the Agency for Healthcare Research and Quality (AHRQ) into the NIH, but maintain the Agency’s $272 million in discretionary funding. Additionally, the method by which AHRQ processes grants would be restructured in order to lower operating costs.
  • The President’s budget would increase industry user fees at the Food and Drug Administration (FDA) by almost 70 percent while reducing taxpayer funding for the agency by 30 percent. Congressional leadership has already said this proposal is de nitely unfeasible given the current status of user fee negotiations. According to a report to congressional appropriators from the FDA, the proposed budget cuts would reduce sta tasked with ensuring medical product safety, and would adversely impact research investments, employee training, and the FDA’s broader mission to protect the public health.
  • The Office of National Drug Control Policy (ONDCP) would be cut by 10 percent, which is far short of the 95 percent cut the Administration previously considered. The decision was praised by the lawmakers most focused on addressing the opioid epidemic.
  • The HHS General Departmental Management funds, which support o ces under the HHS secretary, would be reduced by one-third.
  • The Office of the National Coordinator for Health Information Technology (ONC) would see its budget reduced from $60 million to $38 million in FY 2018. Funding for the O ce for Civil Rights, which investigates HIPAA breaches, would be reduced from $39 million to $33 million.
  • Within the Substance Abuse and Mental Health Services Administration (SAMHSA), the Community Mental Health Services block grant would be cut by $116 million, while other state mental health grants would be reduced by $136 million. Substance abuse treatment grants for states would fall by $73 million and public awareness programs would decline by $74 million.
  • The budget includes medical liability reforms as one of its major savings components. Proposals such as capping non- economic damages, enactment of a statute of limitations, and creation of a safe harbor for clinicians are estimated to produce $55.8 billion in savings.
  • On the issue of drug pricing, the President’s budget expresses support for updating value-based purchasing arrangements, and for encouraging manufacturers to communicate with payers ahead of FDA approval.

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