Department of Health and Human Services (HHS) Secretary Alex Azar Feb. 14-15 testified about the president’s proposed fiscal year (FY) 2019 budget in front of the Senate Finance Committee, House Ways and Means Committee and House Energy and Commerce Committee. Secretary Azar discussed the President’s goals in crafting the budget, which include combatting the opioid epidemic and enhancing and protecting the well-being of the American people.
Several key items of interest to academic medicine were discussed throughout all three hearings. The president’s proposal to consolidate and cap Medicare, Medicaid and Children’s Hospital graduate medical education (GME) funding was widely discussed. During the Feb. 15 Senate Finance Committee hearing, Senator Bill Nelson (D-Fla.) criticized the proposal saying, “Mr. Chairman, in closing I just want to point out that in a growth state like your state, especially my state that is growing at 1,000 people a day, where we educate the doctors and then we don’t have the residency programs, they end up going and doing their residency outside of the state of Florida and they usually stay and practice there. And yet, we have borne the cost of educating them and when you start cutting $48 billion over 10 years to the Graduate Medical Education payments, it going to severely hurt a state like ours that is a growth state that desperately needs those residency programs to keep our doctors.”
Similarly, Sen. Johnny Isakson (R-Ga.) stated, “Those programs are fantastic for creating good physicians and new physicians and health care for children and our elderly.”
Several legislators also showed support for the 340B Drug Pricing Program during the hearings. During the Feb. 15 House Energy and Commerce hearing, Rep. Doris Matsui (D-Calif.) stated, “The flexibility in the program allows hospitals to do things like open new clinics in rural and underserved areas. Why would we want to take that away?” She continued, “The 340B program – a crucial player in our fight against opioids – does not cost a dime of taxpayer money…I cannot understand why it is under attack.”
In the Feb. 14 House Ways and Means hearing, Rep. Mike Thompson (D-Calif.) voiced his opposition to the recent Medicare cut to certain 340B hospitals [see Washington Highlights, Nov. 3, 2017], stating, “The rule, I believe, is seriously misguided and it hurts our hospitals that are big employers and provide critical services. It's bad for jobs, it's bad for our economy, and it's bad for the people that depend upon those services.”
In response to the president’s proposed budget, AAMC President and CEO Darrell G. Kirch, MD, expressed his disappointment saying, “The administration’s proposed cuts would be devastating to patients, current and future providers, the health care safety net, and, ultimately, our nation’s health security.” The proposed budget is unlikely to impact the Congressional appropriations process.