Facing budgetary pressures in his annual spending plan, President Obama has proposed cutting resources from a key part of his health care law — a preventive care program designed for Americans to maintain good health.
Releasing his 2013 budget on Monday, Mr. Obama proposed $360 billion in cuts to Medicare, Medicaid and other health care programs. His ideas are nearly identical to those in the debt-reduction plan he released in September.
Although a part of his chief legislative achievement, the Prevention and Public Health Fund would be cut beginning next year, with a long-term $4.5 billion reduction over the next 10 years.
The cuts could leave the government with fewer resources to accomplish a core aim of the Affordable Care Act, which invests heavily in preventive health programs as a way to cut down on expensive emergency-room visits and prevent illnesses.
When lawmakers passed the health care law, they allocated the prevention fund $15 billion over 10 years to expand prevention and public health programs. But administration officials said Monday that difficult decisions had to be made as the government faces increasing costs for caring for the poor, disabled and elderly.
“We have to make difficult tradeoffs and make sure we use every dollar wisely,” said Bill Corr, deputy secretary of the Department of Health and Human Services. “Our budget makes those tough choices, helping to reduce the deficit even while we invest in areas critical to our nation’s future.”
Mr. Obama’s budget would give HHS 3.7 percent more to spend in 2013, increasing the agency’s budget to $921.6 billion. Forecasting a 9 percent growth in mandatory spending for Medicare and Medicaid, it aims to slow future growth mainly by cutting reimbursements to providers.
Under his plan to cut Medicare by $267 billion, drug providers would have to pay Medicare rebates like they currently pay to Medicaid.
The plan also finds savings by cutting payments to skilled nursing facilities, long-term hospitals and inpatient rehabilitation facilities, reducing the rate at which the government will reimburse providers for copays patients neglect to pay and reducing reimbursements to teaching hospitals.
He would cut Medicaid by $50 billion over the next decade by limiting the taxes states can impose on providers, which they then leverage into more federal reimbursements. He also would streamline the formulas used to determine reimbursements for Medicaid and the Children’s Health Insurance Program, cut supplemental Medicaid payments to some hospitals and limit Medicaid reimbursements for durable medical equipment.
Despite the savings, Republicans said Mr. Obama didn’t go far enough, blasting him for a plan that delays insolvency but doesn’t offer a long-term solution.
“The president acts like these programs are running in the black,” said Sen. Orrin G. Hatch, Utah Republican and chairman of the Finance Committee. “Suggesting only a 1.6 percent reduction to these programs shows his commitment to campaigning over leading.”
House Republicans have promised to release a budget in the spring that would let seniors choose between traditional Medicare and a subsidy to help pay for private insurance. Ways and Means Committee Chairman Dave Camp, Michigan Republican, said Mr. Obama’s plan puts Medicare and Medicaid at future risk.
“Again the president has refused to address the looming bankruptcy in our entitlement programs,” he said. “These programs provide critical income and services to our nation’s seniors and those with disabilities, and they deserve presidential leadership.”