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Michael Petruzzelli

, National Council for Mental Wellbeing

House GOP Budget Would Slash Spending, Block Grant Medicaid

March 24, 2016 | Federal Budget | Medicaid | Comments
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Last week, Chairman of the House Budget Committee Tom Price (R-OK) officially released a GOP budget resolution for FY2017 which would establish top line spending targets for government spending. To date, Congressional Republicans are still at odds within their own party when it comes to agreeing to a topline spending total for the next fiscal year. Speaker of the House Paul Ryan (R-WI) was clear on Tuesday saying that without an agreed upon spending total, House appropriators would be unable to move funding bills to the floor, bringing to a halt the budget and appropriations process.

Previous coverage of the resolution noted that the topline spending levels – $1.07 trillion for 2017 – would meet the agreed upon total in the Balanced Budget Act of 2015, while a separate initiative would be introduced to cut $30 billion in mandatory spending from programs like Medicaid and Medicare. The National Council has recently learned that those proposed cuts would include converting Medicaid to a block grant as well as fully repealing the Affordable Care Act.

 

MANDATORY SPENDING

For provider organizations who rely on Medicaid and Medicare funding to provide mental health and addiction services, these proposed changes could have a drastic, negative impact. Key provisions in the mandatory savings proposal include:

  • Implementation of 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) for states to prioritize its own needs independent of each other;
  • Repeal of the Affordable Care Act (ACA) in its entirety – including the coverage expansions and subsidies. The resolution does not include a framework for a replacement to the health care law; and

The National Council strongly opposes these proposed cuts and changes because of the potentially harmful effect it could have on millions of Americans who rely on Medicare and Medicaid each and every day.

 

DISCRETIONARY SPENDING

Unlike mandatory spending totals, discretionary spending is debated and allocated by appropriators every year. This year’s topline funding number was agreed upon by the White House and GOP congressional leaders in the fall of 2015 with the Balanced Budget Act. However, in Chairman Price’s ten year budget proposal, future years’ topline spending would see dramatic cuts to non-defense discretionary programs, including public health and education programs, veterans’ affairs, and medical and scientific research.

Of particular importance to behavioral health providers, this would mean fewer available resources to be allocated to the Substance Abuse and Mental Health Services Administration, the Centers for Medicare and Medicaid Services and the National Institutes of Health.

“There are not only real consequences of budget cuts, such as job losses, longer wait lists, and curtailed services, but there are opportunity costs, as well,” said Emily Holubowich, Executive Director of the Coalition for Health Funding, of which the National Council is a member. “There are a litany of new and core health activities—advancing precision medicine, combating antimicrobial resistance, curbing the opioid abuse epidemic, investing in the next generation of public health and healthcare professionals—that we should be doing to keep Americans safe and secure that we simply can’t afford to do in this era of austerity.”