WASHINGTON (AP) – Candidate Donald Trump promised to improve health care, but as president his first full budget calls for deep cuts to popular insurance programs. And it omits any proposal for negotiating prescription drug prices, a Trump talking point.
While not addressing Medicare’s long term financial problems, the budget targets the much smaller Children’s Health Insurance Program, or CHIP. And Trump’s Medicaid cuts appear even bigger than those in the health care bill recently passed by House Republicans, above what would be needed to fulfill the GOP vow to repeal “Obamacare.”
Both safety net programs are federal-state collaborations, and such cuts would leave states with hard choices: spend more of their own money; restrict enrollment; cut benefits, or reduce payments to hospitals and doctors.
“If states get fewer dollars from the federal government, there are only so many options, because states have to balance the budget every year,” said Elizabeth Carpenter, a health policy expert with the consulting firm Avalare Health.
Trump’s budget was silent on bargaining with the pharmaceutical industry to reduce the cost of prescription drugs, a topic the president has often touched on. But the budget repeated Trump’s previous proposals for double-digit percentage cuts to the National Institutes of Health and the Centers for Disease Control and Prevention, considered nonstarters even by Republican lawmakers.