HHS proposes $967B budget for 2014

Budget up $60M from last year would boost Medicare enrollment, fund HIXs
By Anthony Brino
10:01 AM

As President 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: Tavenner draws wide bipartisan support at Senate confirmation hearing.]

The proposed budget, HHS Secretary Kathleen Sebelius said at a press conference, 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 the 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 is technically still be finalized amid the sequester) and is almost $120 billion more than the fiscal year 2012 budget of $848 billion.

That $60 billion would be spread across HHS divisions, with some of it reflecting increased Medicare and Medicaid enrollments.

[See also: HHS awards $1.5B for insurance exchanges.]

The Centers for Medicare & Medicaid Services would receive $861 billion (a $60 billion increase over 2013, 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 $31.3 billion (a $274 million increase); and the Office of the National Coordinator for Health IT $21 million (a $5 million increase).

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 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.

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