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Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

Rep. Paul Ryan Releases 2015 Budget Blueprint; Includes Conversion of Medicaid to Block Grant

April 2, 2014 | Federal Budget | Comments
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House Budget Committee Chairman Paul Ryan (R-WI) has unveiled his $1.014 trillion Fiscal Year (FY) 2015 budget proposal, The Path to Prosperity. Congressman Ryan’s budget outlines roughly $5.1 trillion in deficit-reduction proposals over the next decade, including major reforms to Medicare and Medicaid. Key provisions delineated in the latest proposal include:

  • Reasserts certain “state flexibilities” with respect to the administration of the Medicaid program via, once again, a conversion of the Federal share of Medicaid funding to an allotment (effectively, a block grant program) that “each state could tailor to meet its needs, indexed for inflation and population growth.”
  • Repeals the Affordable Care Act (ACA) in its entirety – including the coverage expansions and subsidies; outlines a broad framework for is replacement.
  • Advances the concept of Medicare premium support whereby, beginning in 2024, “seniors (those who first become eligible by turning 65 on or after January 1, 2024) would be given a choice of private plans competing alongside the traditional fee-for-service Medicare program on a newly created Medicare Exchange.” Grandfathers in people who are 56 and older in 2015.
  • Provides the foundation for a long-term (10-year) Medicare physician pay fix, broadly outlining a reimbursement reform framework that would, among other things, “protect seniors enrolled in Medicare Advantage plans from premium increases, benefit reductions and loss of coverage options.”
  • Reinstates proposals that would implement means-tested premiums for high-income seniors under Medicare Parts B and D.

This year’s proposal is scheduled for House Budget Committee consideration on Thursday morning. Senate action on the budget measure, however, is unlikely this year. For more information, see the budget resolution summary tables, legislative text, and CBO score.