HHS FY 2018 Budget in Brief - CMS - Overview

Centers for Medicare & Medicaid Services (CMS): Overview

CMS logoThe Centers for Medicare & Medicaid Services ensures availability of effective, up-to-date health care coverage and promotes quality care for beneficiaries.

CMS Budget Overview

(Dollars in millions)

Current Law /1 2016 2017 2018 2018
+/- 2017
Medicare /2 594,483 599,678 593,154 -6,524
Medicaid 368,280 378,455 407,570 +29,115
CHIP 14,358 16,879 12,017 -4,862
State Grants and Demonstrations 553 537 534 -3
Other Health Insurance Programs 11,561 9,637 7,225 -2,412
Center for Medicare and Medicaid Innovation 1,156 1,294 1,408 +114
Total Net Outlays, Current Law /3 990,391 1,006,480 1,021,908 +15,428
Proposed Law  2016 2017 2018 2018
+/- 2017
Medicare—Benefits /2 - - 39 +39
Medicare  - Administration     2 +2
Medicaid - - -3,857 -3,857
CHIP - - 1,400 +1,400
Medical Liability Reform Impacts (non-add) - - -149 -149
Discretionary Program Management - - 26 +26
Total Proposed Law - - -2,390 -2,390
Total Net Outlays, Proposed Law /4 990,391 1,006,480 1,019,559 +13,059
Savings from Program Integrity Investments /5 - - -102 -102
Total Net Outlays, Proposed Policy 990,391 1,006,480 1,019,416 +12,936

Table Footnotes

1/ Reflects the annualized level of the Continuing Resolution that ended April 28, 2017, including the across the board reduction, the 21st Century Cures Act, and directed transfers.
2/ Current law Medicare outlays net of offsetting receipts.
3/ Totals may not add due to rounding.
4/ Total net proposed law outlays equal current law outlays plus the impact of proposed legislation and offsetting receipts.
5/ Includes non-PAYGO scorecard savings from discretionary Health Care Fraud and Abuse Control Program (HCFAC) above savings already assumed in current law.

The Centers for Medicare & Medicaid Services ensures availability of effective, up-to-date health care coverage and promotes quality care for beneficiaries.

The Fiscal Year (FY) 2018 Budget estimate for the Centers for Medicare & Medicaid Services (CMS) is $1 trillion in mandatory and discretionary outlays, a net increase of $13 billion from the FY 2017 level.  This request finances Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), other health insurance programs, program integrity efforts, and operating costs.  CMS’s legislative package promotes fiscal responsibility, State flexibility, and curbs the practice of defensive medicine.  In total, the Budget proposes targeted savings of $636 billion to CMS Federal health benefit programs over the next decade.

Budgetary Request

CMS is dedicated to moving toward a health care system that will drive down costs, give Americans more choices, and put patients and doctors in control of their health care.  To achieve this, CMS will empower patients and doctors to make decisions about their health care while reducing burdensome regulations and building a patient-centered system of care that increases competition, quality, and access.  CMS will usher in a new era of state flexibility and local leadership.  Because the States are in the best position to assess the unique needs of their populations and drive reforms, this shift will result in better health care outcomes. 

The Budget does not include any direct Medicare cuts. The Budget proposes to repeal the Independent Payment Advisory Board and also provides resources and signals a commitment to reform the Medicare appeals process.

Medicaid and CHIP

CMS FY 2018 Net OutlaysThe Budget includes legislative proposals in Medicaid and CHIP, which have a net savings of $616 billion on Federal spending over 10 years.  The Budget makes fundamental reforms to Medicaid’s fiscal structure and gives States greater flexibility to implement solutions reflective of the needs of their unique populations.  The Budget includes an initiative that helps to rebuild the patient-physician relationship.  Finally, the Budget extends CHIP for two years through FY 2019, along with reforms to return the focus of the program to the most vulnerable low-income families and children that the program was intended to serve.

Repeal and Replace
The Budget includes $250 billion in net deficit savings over 10 years related to repealing and replacing Obamacare, and implementing reforms that provide the American people with access to the kind of high-quality, affordable care that works best for them.  The Budget promotes efficient operations and funds necessary activities to continue to operate the Exchanges in 2018. This will provide for a stable transition from the burdensome requirements of Obamacare to a patient-centered health care system.This includes $3 billion in savings to Exchange subsidies and related impacts, reflected in the Department of Treasury programs and accounts.


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