As expected, the White House budget repeats previous proposals by President Obama to cut Medicare and other health programs by about $400 billion over the next decade. The largest of these savings — about $123 billion over 10 years — would come from requiring drug makers to offer Medicare the same lower prices and rebates for prescription medications that they currently charge the Medicaid program.
Obama also wants to speed up a measure in the 2010 health-care law that already requires manufacturers to provide steadily larger drug discounts to Medicare enrollees through 2020. The additional savings would amount to $11 billion over 10 years.
The budget would also increase Medicare premiums charged to higher income beneficiaries — for a savings of $50 billion over the next decade. Another big ticket item: slashing $81 billion out of the rates Medicare pays providers of “post-acute care” such as skilled nursing facilities and hospitals, which the administration argues are often over-compensated.
Overall, the budget would provide the Department of Health and Human Services $80.1 billion in discretionary funding — only $3.9 billion more than the agency received last year.
But that relatively small change masks boosts to some programs and significant cuts to others.
On the plus side of the ledger are two measures with particular resonance in the wake of Newtown, Conn., school shootings: A new $130 million initiative to expand mental health services, including training for social workers and other professionals who work in schools; and an extra $30 million for programs that research ways to prevent violence.
On the chopping block: a grant for preventive health services and a program that helps low-income people pay their energy bills — reductions the administration described as “difficult trade-offs.”