On Tuesday, the White House released its budget for fiscal year 2015, asking Congress to appropriate nearly $4 trillion, significantly higher than more recent budget proposals. The budget calls for additional funding for infrastructure, education, and job training. It sets forth an ambitious blueprint for Democratic priorities, which was likely crafted more as a tool to use in the upcoming mid-term election than as a working budget proposal. Noticeably absent from the proposal is a provision to tie Social Security rate increases to chained CPI, which was a major concession the administration made in prior budget proposals.
Republican lawmakers quickly slammed the budget proposal for increasing spending and taxes. It is unlikely to pass the Republican-controlled House. Rep. Paul Ryan (R-WI), who serves as the House Budget Committee Chairman, said "This budget isn't a serious document, it's a campaign brochure." He plans to release the House's budget plan next month. Prior Ryan budget proposals have called for converting Medicaid to a block grant program, and converting Medicare to a voucher system in which seniors receive subsidies to purchase private insurance.
Medicaid funding totals are slightly higher than FY2014 levels. The budget would extend the Medicaid primary care payment increase through 2015, with the federal government covering the difference between the Medicaid and Medicare rate. Other notable Medicaid-related provisions in the budget include funding tied to:
- Rebasing future disproportionate share hospital allotments;
- Permanently extending express lane eligibility for children in CHIP;
- Limiting Medicaid reimbursement of durable medicaid equipment based on Medicare rates;
- Providing home and community-based waiver services to children and youth eligible for psychiatric residential treatment facilities;
- Lowering Medicaid drug costs for states and the federal government;
- Improvements to program integrity for Medicaid drug coverage;
- Increasing access to and transparency of Medicaid drug pricing data;
- Expanding state flexibility to provide benchmark benefit packages;
- Extending transition medical assistance through 2015;
- Extending the qualified individual program through 2015;
- Additional Medicaid program integrity proposals to combat fraud, waste, and abuse.
The Department of Health and Human Services' overview of the budget, which includes detailed breakdowns of Medicaid and Medicare provisions, is available here.