In a surprising May 28 late-evening tweet, President Donald Trump called for more money to be spent on healthcare, a proposal that conflicts with his fiscal-year 2018 budget request and a bill that passed the House, which he supported.
"I suggest that we add more dollars to Healthcare and make it the best anywhere. ObamaCare is dead — the Republicans will do much better!" Trump tweeted.
The White House did not respond to requests from S&P Global Market Intelligence to clarify which programs the president was asking Congress to allocate additional healthcare dollars.
But in his budget proposal unveiled May 23, Trump asked Congress to make big cuts to healthcare programs, including $610 billion from Medicaid over 10 years. The president also wants to slash nearly $6 billion from the National Institutes of Health's budget for fiscal-year 2018, including $1 billion from the National Cancer Institute and $838 million from the National Institutes of Allergy and Infectious Diseases.
"I do not believe you make America great again by cutting medical research to the lowest level in 12 years," Sen. Dick Durbin, D-Ill., the Senate Democratic whip, said May 28 on "Fox News Sunday." Republican and Democratic lawmakers alike have made assurances they have no interest in cutting the NIH's funding.
Trump is also seeking to strip more than $1 billion from the Centers for Disease Control and Prevention, including $136 million from the agency's public health preparedness and response funds for 2018.
Healthcare bill spending cuts
The House Republicans' bill to repeal the Affordable Care Act, known as the American Health Care Act, which was adopted by that chamber in a 217-213 vote on May 4, would cut over $800 billion from Medicaid spending, according to the latest estimate from the Congressional Budget Office, which provides nonpartisan financial analyses to Congress.
Trump supports the House-passed bill, and the White House said the president worked with Congress to ensure the president's core principles were incorporated into the legislation.
Senate Republicans, however, are working on their own bill, which they started from scratch.
"The Senate will have its own product," Sen. Bill Cassidy, R-La., confirmed May 28 on "Fox News Sunday."
A 13-member, all-male panel of Republican senators has been charged by Senate Majority Leader Mitch McConnell, R-Ky., with drafting the legislation.
The Trump administration has also signaled that it may stop making the ACA's cost-sharing reduction payments to insurers, which help cover deductibles and copayments for about 7 million low-income Americans enrolled in plans offered by private insurers through the government-run marketplace.
The administration on May 22 filed for a three-month delay in seeking an appeal in a case it inherited from the Obama administration in which House Republicans sued and won to stop the payments.
Marilyn Tavenner, president and CEO of America's Health Insurance Plans and a former administrator at the Centers for Medicare and Medicaid Services during the Obama administration, warned in April that if the payments stop, many insurers would drop out of the market, premiums would rise by nearly 20% and taxpayer costs would increase.
Several insurance companies have already pulled out of the ACA marketplace.
In a May 19 letter to Republican and Democratic leaders, AHIP, joined by the American Academy of Family Physicians, American Benefits Council, American Hospital Association, American Medical Association, Blue Cross Blue Shield Association, Federation of American Hospitals and the U.S. Chamber of Commerce, said there was now "clear evidence" the continued uncertainty around the cost-sharing payments was "undermining the individual insurance market for 2018 and stands to negatively impact millions of people."
They noted that millions of Americans do not receive health insurance through an employer, Medicare or Medicaid and the individual market "is their only option for getting coverage," and urged Congress to immediately take action to guarantee a steady stream of cost-sharing payments through 2018.
"We have to have an effort made to sustain the current system while we repair it. We shouldn't be sabotaging it," Durbin said on "Fox News Sunday."