The Latest: Budget proposes limit on Medicare drug prices

WASHINGTON (AP) — The Latest on President Donald Trump’s proposed 2020 budget (all times local):

2:25 p.m.

President Donald Trump’s budget proposes a hard limit to what Medicare beneficiaries have to pay for prescription medications, an idea with bipartisan support in Congress.

The Medicare prescription drug benefit was enacted more than 15 years ago, before drugs costing $1,000 a pill or more came along. Right now beneficiaries with high costs face a co-pay of just 5 percent, but that can still amount to thousands of dollars for the most expensive medications.

The actual dollar amount of the cost cap would be determined in conjunction with Congress. One lawmaker’s proposal would set the limit at about $2,650.

The cap on cost sharing is part of several changes the budget would make to Medicare’s popular “Part D” prescription benefit. It’s not clear if all will find support.


2 p.m.

Anti-AIDS activists are condemning proposed cuts for worldwide efforts to fight the disease in President Donald Trump’s new budget request.

Activists say the global cuts are at cross-purposes with the $291 million in additional spending that Trump has requested for an effort to virtually eliminate new HIV infections in the United States.

The budget calls for a 22 percent cut to PEPFAR, the U.S. program that has helped treat millions internationally, mostly in Africa, according to The ONE Campaign. That global health advocacy organization is associated with the musician Bono.

Trump is also proposing to change the financing formula another program, the Global Fund to Fight AIDS, Tuberculosis and Malaria, so that the U.S. contribution is watered down. The budget calls for $1.1 billion for the Global Fund, down from $1.35 billion, the current level as reported by the Kaiser Family Foundation.


1:20 p.m.

President Donald Trump’s budget calls for collecting $100 million in new fees from the electronic cigarette industry to help combat a surge in underage vaping.

E-cigarettes are battery-powered devices that typically heat a nicotine solution into an inhalable vapor. Most experts agree they are less harmful than traditional cigarettes, but officials at the Food and Drug Administration and other health agencies were caught off guard last year by an explosion in underage use by teenagers. About 1 in 5 high school students reported using e-cigarettes last year, according to the most recent federal survey data.

The fees “would ensure that FDA has the resources to address today’s alarming rise in youth e-cigarette use,” and related future problems, the budget states. The FDA already collects about $700 million in fees annually from makers of cigarettes, chew and other traditional tobacco products.

E-cigarettes were not part of the 2009 law that gave FDA authority to regulate key parts of the tobacco industry, and to collect fees from companies.


1:17 p.m.

President Donald Trump’s budget would provide $291 million to launch a campaign to eliminate 90 percent of HIV infections in the U.S. within 10 years.

Announced earlier in the State of the Union speech, the plan has been welcomed by some AIDS activists, though others remain wary of the administration.

It relies on early testing, use of anti-infective medications to prevent new cases, and drug treatment to suppress the virus in people already infected.

The campaign is focused on 48 mainly urban counties and rural areas of seven states with high rates of HIV infection.

According to the Kaiser Family Foundation, the government will spend $28.1 billion this year domestically on HIV/AIDS, including care and treatment, research, and prevention. The U.S. also contributes to overseas efforts.


1:10 p.m.

President Donald Trump again is asking Congress to slash funding for the Environmental Protection Agency by about a third, a request that lawmakers have rejected previously.

The White House’s 2020 budget request on Monday seeks $6.1 billion for the EPA, down 31 percent from the previous year.

The White House says it aims to ensure clean air and water and chemical safety, while “reducing regulatory burden and eliminating lower-priority activities.”

EPA Andrew Wheeler called it a “commonsense budget proposal.”

But Ken Cook of the Environmental Working Group says it would work to appease Trump’s base and the fossil fuel and chemical industries.

Trump’s previous attempts to slash the EPA budget have been rejected by Congress.


12:45 p.m.

The Trump administration wants to cut Education Department funding by 10 percent while expanding money for school choice, school safety and apprenticeship programs.

Department leaders on Monday released a $64 billion budget proposal that makes many of the same requests Congress denied last year.

The proposal would eliminate 29 programs, including a $2 billion program meant to help schools improve instruction, and a $1.2 billion program to create community centers.

Meanwhile it would add $60 million for charter schools and $200 million for school safety initiatives.

Education Secretary Betsy DeVos says the plan would help taxpayers by ending programs “that are better handled at the state or local level.”

DeVos also proposed up to $5 billion a year through the Treasury Department for federal tax credits supporting school choice scholarships.


12:30 p.m.

President Donald Trump’s budget would re-open two health care battles he already lost in his first year in office: repealing “Obamacare” and limiting future federal spending on Medicaid for low-income people.

With Democrats in charge of the House, Trump’s grand plan has no chance of being enacted. And few Republican lawmakers want to be dragged into another health care fight.

Under the budget, both programs would be turned over to the states starting in 2021.

The Affordable Care Act would be replaced with grants that states could use to subsidize private insurance coverage, and Medicaid would be replaced with a block grant instead of the current open-ended federal commitment. Future federal spending increases would be tied to the rate of general inflation, which is lower than health care inflation.


12:25 p.m.

President Donald Trump is seeking just over $93 billion for the Department of Veterans Affairs in his budget proposal for 2020, an increase of $6.5 billion from the year before.

The president’s request would support the implementation of a bill Trump signed into law last year to give veterans more freedom to see doctors outside the troubled Veterans Affairs system, a major shift aimed at reducing wait times and improving care by steering more patients to the private sector.

An overview of the budget says reducing veteran suicides would be a top priority. The plan also sets aside $4.3 billion for information technology investments to “improve the online interface between the veteran and the department.”

Congress will examine the president’s recommendations as it considers the overall 2020 government spending blueprint.


11:30 a.m.

President Donald Trump is relying on an optimistic projection of 3.1 percent economic growth to bring his proposed $4.7 trillion budget into balance in the future, along with accounting shuffles and steep cuts to domestic programs.

The 2020 budget released Monday projects a $1.1 trillion deficit for the fiscal year beginning Oct. 1.

Trump is banking on robust economic growth, but some economists say the boost from the Republican tax cuts are waning. The non-partisan Congressional Budget Office projects growth to slow to 1.7 percent in coming years.

Presidential budgets are rarely enacted, but Trump’s sets up a new confrontation with Congress. He proposes boosting defense dollars but shifting some of it to a contingency account that doesn’t count toward budget caps. He also wants an additional $8.6 billion for the U.S.-Mexico border wall.


8:25 a.m.

President Donald Trump’s budget chief confirms that the president will ask Congress for $8.6 billion for his proposed wall along the U.S. border with Mexico as part of his 2020 budget proposal.

Russ Vought, the acting director of the Office of Management and Budget, says the “the border situation is deteriorating by the day” with “record numbers of apprehensions.” The $8.6 billion is in addition to the billions of dollars Trump seeks to secure for the wall through the national emergency at the border he declared last month.

Vought, speaking on CNBC, says the proposed budget will also have cuts in discretionary spending, such as foreign aid and in welfare “reforms.” He added that the White House also wants “reforms” to student loans and federal retirement programs.

Vought said, “Many of the reforms that we have are not what we would call a cut. Many of them are savings and reforms to make programs work better.”

Democrats have called the proposed cuts to essential services “dangerous.”


12:40 a.m.

President Donald Trump’s new budget is returning to an old fight over spending on a border wall with Mexico.

The president’s proposal, set for release Monday, also seeks to increase spending for the military but cut back sharply on money for domestic programs in the name of fiscal responsibility.

Trump’s acting budget chief, Russ Vought, says the administration has “prioritized reining in reckless Washington spending.”

Democrats aren’t buying it. The chairman of the House Budget Committee, congressman John Yarmuth of Kentucky, calls the proposed cuts to essential services “dangerous.”

Congress’ top Democrats, House Speaker Nancy Pelosi and Senate leader Chuck Schumer, predict that Trump’s latest demand for border wall money will result in another defeat for the president. They say the money would be better spent on rebuilding the country.

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