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Breaking down President Obama's FY 2013 budget: Health and human services

While most people were occupied with last-minute Valentine’s Day preparations earlier this week, President Obama was busy announcing the FY 2013 budget. Rest assured that Deltek will be analyzing every inch of the data to uncover key trends and opportunities for our member network. This analysis will focus on funds trickling down to the states from the health and human services vertical. The Department of Health and Human Services’ (DHHS) Deputy Secretary Bill Corr spoke to the public on Feb. 13 and highlighted the health objectives the budget package addressed. DHHS plans to strengthen the nation’s health care, continuing on the Affordable Care Act (ACA) of 2010. Initiatives include health insurance exchange development, expanding community health programs, and increasing the health care workforce. Fighting fraud, waste, and abuse continues to be priority number 1 – the department collected almost $4 billion last year in improper payment recoveries. Corr also stated the FY 2013 budget and, specifically, Medicaid reform will help reduce the federal deficit by $366 billion over 10 years.
 
Following the same trend as last year, discretionary spending (Table 1, below) is set at $30 billion, which is down nearly 3.5 percent from FY 2011. Programs seeing major cuts include the public health and social services emergency fund and low-income home energy assistance (LIHEAP). The Distance Learning, Telemedicine, and Broadband Program saw a 68 percent increase to $42 million, following through on DHHS’ promise to strengthen health care, especially in rural areas. Mandatory spending (Table 2) also corresponded with DHHS goals and saw an 82 percent increase in funding for health insurance exchange establishment, totaling $868 million. Grant funding to states for Medicaid totals $269 billion. Stay tuned for FY 2014 numbers as eligibility enrollment is estimated to increase by nearly 16 million Americans. 

Table 1: Federal Grants to State and Local Governments, Discretionary (in millions of dollars)

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Table 2: Federal Grants to State and Local Governments, Mandatory  (in millions of dollars)

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Other areas of the budget proposal include:

  • Temporary Assistance for Needy Families (TANF): TANF funding rises nominally to $17 billion in FY 2013.
  • Supplemental Nutrition Assistance Program (SNAP): The budget includes $7 billion in SNAP benefits, a 5 percent increase from FY 2011. Although states are seeing record food stamp numbers, the Department of Agriculture (USDA) transferred $400 million to support the Women, Infants, and Children (WIC) Program for FY 2012.
  • WIC: Program funds increased by 14 percent to $7 billion, which includes $14 million for infrastructure funding and $30 million for management information systems.
  • Child Support Enforcement: Funding took a 7 percent dip to $3.8 billion. The budget request includes new investments of $305 million in FY 2012 and $2.4 billion over ten years for the Child Support and Fatherhood Initiative.
  • Child Care: Proposes $6 billion for child care, which includes $2.6 billion for the Child Care and Development Block Grant to supplement assistance for low-income families; and entitlement to states is $3.4 billion.
  • Child Welfare: Requests $7.2 billion for foster care and permanency services including adoption and guardianship assistance, foster care, and independent living.
Overall, the FY 2013 budget produced minimal funding changes for health and social services programs. Vendors playing in the health care field will see the most benefit in those pocket areas of increased funding, especially surrounding health insurance exchange implementation, Medicaid system reform, and eligibility redetermination. Those thinking that the ruling on the ACA later this summer will stem exchange development should think again. Many states are planning to continue developing systems whether the act holds or not. With the major push to cut down on federal spending and fight abuse in the human services arena, vendors need to keep reporting systems up to date with all required mandates and regulations. As health information exchanges start to be rolled out this year, it should be interesting to see which states will find success in transferring electronic medical records, and which will not. It seems that health care will continue to be the hot topic of FY 2012 and FY 2013.

 

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