As President Barack Obama takes his budget and deficit-reduction proposals to Congress and the public, the Department of Health and Human Services has unveiled its proposed budget for the 2014 fiscal year.
The $967 billion budget includes funding increases for programs in the Centers for Disease Control and Prevention, the National Institutes of Health, early childhood education, mental health and substance abuse treatment and Affordable Care Act implementation, with certain portions of the budget subject to congressional approval, such as a $1.5 billion request for federally-facilitated insurance exchanges.
[See also: HHS announces $10.4M in rural health grants]
The proposed budget, HHS Secretary Kathleen Sebelius said at a press conference on Wednesday, will help the agency pursue the Obama administration's "North Star of a thriving middle class," with continuing funding for public support programs, consumer protections and expanded healthcare access under the ACA and workforce development in behavioral health and biomedical research.
At the same time, she said, the agency is trying to be more efficient by "seeking out savings everywhere we can," and by expanding fraud prevention and enforcement programs. HHS' Office of Inspector General would receive $389 million in discretionary and mandatory funding under the proposed budget, an increase of $101 million over the previous year.
The $967 billion proposed budget ($80 billion of it in discretionary monies) is a roughly $60 billion increase over fiscal year 2013 (which, as Sebelius pointed out, has technically still to be finalized amid the sequester) and is almost $120 billion more than the fiscal year 2012 budget of $848 billion.
The $60 billion increase would be spread across HHS divisions, with some of it reflecting increased Medicare and Medicaid enrollments.
The Centers for Medicare & Medicaid Services would receive $861 billion (a $60 billion increase over 2013 with some of it actually coming from the Social Security Administration); the Food and Drug Administration, $2.5 billion (a $400 million increase); the Health Resources and Services Administration, $9.2 billion (a $430 million increase); the CDC, $6.3 billion (a $290 billion increase); the National Institutes of Health, (NIH) $31.3 billion (a $274 million increase); and the Office of the National Coordinator for Health IT, $21 million (a $5 million increase).
[See also: Budget battles and oversight on Congress' radar screen]
The budget projects increased Medicare enrollment, growing from 52 million seniors currently to 53.6 million in 2014. At the same time that Medicare becomes a focal point of federal spending in debates over the deficit, the budget proposes $5.6 billion in Medicare payment reductions for fiscal year 2014, while Medicare spending in total would increase about $20 billion, to $524 billion. Medicaid spending would increase by $37 billion, to $303 billion.
The proposed budget as a whole would save a projected $393 billion in Medicare and Medicaid spending over the next decade, Sebelius said. $120 billion of that would come through letting Medicaid-Medicare dual-eligible enrollees buy prescription drugs at Medicaid rates, which are lower than Medicare.
Sebelius added that the $31.3 billion included in the budget for NIH will be used to support research institutions across the country, including enhancing the commitment to invest in Alzheimer's research.
The budget includes a new $130 million initiative to expand mental health treatment and prevention services, including $55 million for Project AWARE (Advancing Wellness and Resilience in Education) to provide mental health "first aid" training in schools and communities and to help school districts and their communities work together to ensure that students with mental health issues are referred to the services they need; $50 million to train 5,000 new mental health professionals to serve students and young adults, including social workers, counselors, psychologists and other mental health professionals; and $25 million for Healthy Transitions, a new competitive grant to help support transitioning youth (ages 16 to 25) and their families access and navigate behavioral health treatment systems.
To increase access to high-quality healthcare, the budget provides increased resources for primary care training programs and support for healthcare providers who choose to train and practice in medically-underserved areas. This includes funding that will support over 8,800 healthcare professionals practicing in underserved areas. In addition, the budget initiates investments that will help train more than 2,800 additional primary care providers estimated to enter the workforce over the next five years.
Continuing with efforts to improve Americans' access to preventive healthcare regardless of their ability to pay, the budget also invests $3.8 billion for health center services in 2014 to support services to an estimated 22 million patients. The ACA provides the Health Center program with a total of $9.5 billion through 2015.
Kelsey Brimmer, Associate Editor of Healthcare Finance News, contributed to this story.
