President Trump Releases Fiscal Year 2020 Request to Congress

President Trump released his Fiscal Year 2020 Request to Congress entitled A Budget for Better America. Promises Kept. Taxpayers First. Below is a brief initial update regarding President Trump's Request to Congress from INARF's national partner, ANCOR.
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The President's request initiates the budget process and also simultaneously sets out the Administration's policy priorities for the year but these numbers and programs are just ideas for now - Congress is now charged to work or not work it into their spending bills, pass those, and then the President signs the final spending bills to complete the budget process. 

• First item to note - Block grant and per capita cap proposals are back! 
  • The President's budget request revives the Graham/Cassidy/Heller/Johnson proposal and seeks savings in Medicaid through per capita cap and block grants for states. Check out page 43 of the report for this positioning and page 128 for the projected savings in Medicaid. 
• In addition to reforming Medicaid, the budget also sets out to reduce wasteful Medicaid spending
  • This shows itself in an interesting way - on the table on page 122 you'll see projected savings to "implement pre-payment controls to prevent inappropriate personal care services payments" with 700 million savings beginning in FY 2020. To give you some perspective, this is more than twice the 10 year projected savings of the new EVV requirements. We will find out more about this proposal  - remember that the majority of HCBS services fall under the definition of "personal care services" so it is very relevant to us! 
• You can see the outlays for the overall Medicaid program on page 109 - in FY 2020 we are only jumping up from 419 billion to 426 billion for the entire program. 
• Of really interesting note - one of the small handful of items recommended to "Restrain spending to protect and respect American taxpayers" on page 108 is to "reform disability programs and test new approaches." You can see more details of this on page 129 which includes a mix of improving employment of people with disabilities while also restricting Social Security funds to families with multiple children with disabilities.