15 things for healthcare leaders to know about Obama's 2017 budget

Ayla Ellison -

President Barack Obama shared his $4.1 trillion budget proposal Tuesday for the 2017 fiscal year, which begins Oct. 1.

Here are 15 of the budget's key proposals related to healthcare.

1. Biomedical research funding. The 182-page plan allots $33.1 billion to support biomedical research at the National Institutes of Health, providing about 10,000 new and competing NIH grants. Although the budget has already faced criticism from Republicans, several GOP members have pledged to support an increase in biomedical research spending, according to The Hill.

2. Funding for the cancer moonshot. President Obama signed a memorandum in January to officially kick off Vice President Joe Biden's "moonshot" initiative to improve cancer care and research. The budget supports this effort with a $1 billion initiative to provide the funding necessary to accelerate the development of new cancer detection and treatments, including $755 million in mandatory funds in the 2017 budget for cancer-related research activities. This proposal could ultimately yield bipartisan agreement, according to The Wall Street Journal.

3. Tackling prescription drug abuse. The budget takes a two-pronged approach to addressing the prescription drug abuse and heroin use epidemics. The budget includes about $500 million to continue current efforts across HHS and the Department of Justice to expand state-level prescription drug overdose prevention strategies, increase the availability of medication-assisted treatment programs and improve access to the overdose-reversal drug naloxone. The budget also includes $1 billion in new mandatory funding over the next two years to help individuals seek substance abuse treatment. States would receive funds based on the severity of the epidemic and on the strength of their strategy to respond to it.

4. Mental healthcare funding. The budget allots $500 million in new mandatory funding over two years to help individuals with serious mental illness receive care. The funds will be used to improve access to care by increasing service capacity and the behavioral health workforce.

5. Researching antibiotic-resistant bacteria. The budget dedicates $1.1 billion to prevent, detect and control illnesses and death related to infections caused by antibiotic-resistant bacteria. The funds will also be used to support research and innovation in the reduction and management of antibiotic-resistant bacteria.

6. Building the primary care workforce. The budget calls for increasing the number of National Health Service Corps clinicians who practice primary care to 15,000 in the areas where they are most in demand. The budget also supports primary care residency programs in medically underserved area.

7. Lowering prescription drug costs for the Medicare program. The budget includes a number of proposals to lower drug costs while improving transparency in the Medicare Part D program. Those proposals include increasing data collection to demonstrate the effectiveness of medications in the Medicare population and incentivizing Part D plan sponsors to better manage care provided to beneficiaries with high prescription drug costs. The budget also proposes to accelerate discounts for brand name drugs for seniors who fall into Medicare's coverage gap by boosting manufacturer rebates from 50 percent to 75 percent in 2018. The proposals related to lowering drug costs for Medicare would save the program approximately $140 billion over 10 years.

8. Cutting Medicaid prescription drug costs. The budget calls for the creation of a federal-state Medicaid negotiating pool for high-cost drugs. Other targeted proposals include improving the Affordable Care Act Medicaid rebate formula for new drug formulations. The proposed reforms related to Medicaid drug costs are projected to save the federal government $11.4 billion over 10 years.

9. Increasing transparency of prescription drug pricing. HHS would have authority to require drug manufacturers to publicly disclose certain information, including research and development costs, under the budget proposal. The budget also includes three previously proposed reforms aimed at increasing access to generic drugs and biologics. Over the next 10 years, these proposals would save the federal government $21 billion.

10. Strengthening Medicare Advantage. The budget proposes to reform payments to Medicare Advantage plans by using competition to set payment rates. Medicare Advantage payment rates would be based on plans' bids, ensuring that plan payments reflect their costs for covering Medicare beneficiaries. These and other Medicare Advantage reforms included in the budget proposal would save about $77 billion combined.

11. Preserving CHIP coverage. The Medicare Access and CHIP Reauthorization Act extended Children's Health Insurance Program funding through 2017, and the budget proposes to extend funding through 2019.

12. Cutting healthcare fraud and abuse. The budget includes a number of proposals to help reduce fraud and waste in the Medicare and Medicaid programs. Those proposals include improving the Recovery Audit Contractor program and ensuring federal and state governments can confidentially share data algorithms to detect waste, fraud and abuse.

13. Pushing Medicaid expansion. As an incentive to expand Medicaid, the budget calls for the federal government to cover the full cost of expansion for the first three years regardless of when a state expands. Previously, the ACA covered the full costs through calendar year 2016 before reducing the level of support to 90 percent.

14. Promoting access to long-term care services. The budget proposes expanding and simplifying eligibility to encourage more states to provide home and community-based services in their Medicaid programs. The budget also includes a long-term care pilot for up to five states to test. Additionally, the budget provides $10 million for home and community-based services provided through HHS' Administration for Community Living.

15. Improving Native American healthcare. To expand healthcare services and make progress toward the construction of healthcare clinics in Indian Country, the budget provides the Indian Health Service with $5.2 billion, an increase of more than $400 million over 2016.

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