White House’s Proposed Budget Targets Nation’s Hospitals

April 4, 2019

The White House’s fiscal year (FY) 2020 budget blueprint, “A Budget for a Better America: Promises Kept. Taxpayers First.” includes multiple proposals that would harm hospitals in New York State and nationwide. While large portions will be dismissed outright, parts could be taken up in future legislative and regulatory proposals

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 Medicaid 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
  • 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 health insurance marketplaces and Medicaid: a $800 billion cut over 10 years
  • Alter the Centers for Medicare & Medicaid Services’ 2018 cuts to 340B 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

GNYHA will work vigorously with our allies to oppose these proposals and ensure they aren’t enacted either legislatively or via the regulatory process. Additional information on this dangerous budget can be found here.