House and Senate Release Proposed Budgets
Monday, March 18, 2013
by: VNAA Policy Team

Section: Public Policy and Advocacy

On March 12, House Budget Committee Chair Paul Ryan (R-MN) released his FY 2014 proposed budget. Later in the week on March 13, Senate Budget Committee Chair Patty Murray (D-WA) released her version of the 2014 budget. The budget proposals put forward a vision for federal spending and provide a framework for legislative priorities. They do not always contain a lot of detail about how proposals would work or exactly how savings targets would be met, often raising more questions than they answer.

Representative Ryan’s budget resolution is similar to proposals he has put forward in the past. It would turn Medicare into a premium support system beginning in 2014 for those born in 1959 or after; change Medicaid from an entitlement to a block-grant program; and repeal the Affordable Care Act (ACA) while keeping the ACA’s Medicare cuts intact. Ranking member Chris Van Hollen (D-MD) said House Democrats would release their budget plan the week of March 18. House Democrats strongly rejected Ryan’s budget, charging that turning Medicare into a premium support system would increase costs to seniors and that block granting Medicaid would be a burden to states.

Senator Murray’s budget resolution would reduce health care programs by $275 billion over 10 years but notably does not detail how they would achieve those savings. It suggests numerous big picture ideas including realigning system incentives, cutting waste and fraud, and seeking engagement across the healthcare system. Senate Budget Committee ranking member Jeff Sessions (R-AL) said the budget produced by Democrats does not eliminate deficits, and he criticized it for not including entitlement reforms.

Both the House and Senate budget proposals contain reserve funds for a permanent Medicare physician pay fix.

The White House is expected to release its fiscal 2014 budget blueprint the week of April 8. In his State of the Union, the President suggested he would look at the deficit reduction policies included in the Simpson-Bowels plan, which includes a single, combined annual deductible for Medicare Parts A and B, along with a uniform coinsurance. The press reported that the President supported “combining” Parts A and B during a closed-door meeting of House Republicans. The Administration has previously stated that it would not include any large-scale Medicaid proposals in this budget. No further details will be available until we see the formal budget release. 
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