Medicare and Medicaid programs get a boost under President Bushs budget proposal in fiscal 2009, although providers are decrying the plans longer-term cuts to their payments.
The budget request includes $425 billion for Medicare, a $29 billion increase from $396 billion in 2008. Medicaid would receive $217 billion, an increase of $13.7 billion from 2008s appropriation. Overall, the president is requesting $737 billion for HHS in fiscal 2009, a $29 billion increase from 2008.
However, the request also includes legislative and administrative proposals to cut Medicare by $183 billion and Medicaid by $17 billion over the next five years. These cuts are necessary to sustain the Medicare program, which is going broke in 11 years, said HHS Secretary Mike Leavitt. If these cuts go through, Medicares budget for fiscal 2009 would be closer $413 billion, and Medicaids budget would be $215 billion, a decrease of nearly $2 billion.
Hospital and other provider payments account for a sizable portion of these cuts. The presidents Medicare proposal would cut inpatient hospital payments by nearly $4 billion in fiscal 2009 alone and $64 billion over five years. In the real world, these enormous budget numbers come with enormous consequences, making hospitals job of caring for patients even more difficult, Richard Umbdenstock, president and chief executive officer of the American Hospital Association, said in a written statement.
Acting CMS Administrator Kerry Weems countered that hospitals may claim their Medicare margins are shrinking, But I would argue that they also have substantial access to capital, and that more are joining the Medicare program than leaving.
The proposed budget no legislative solutions to fix Medicare's troubled formula for setting payments to physicians.-- by Jennifer Lubell
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