The budget also boost funding for the America's Great Outdoors initiative, an Obama program intended to promote outdoor recreation in national parks, wildlife refuges and other public lands.
In a move sure to irk coal-state lawmakers, Obama again calls for changing a fee system designed to clean up abandoned coal mines. States with no abandoned mines would not receive payments.
Agency: Health and Human Services
Total Spending: $949.9 billion
Percentage Change from 2013: 5.4 percent
Discretionary Spending: $78.3 billion
Mandatory Spending: $871.6 billion
Highlights: The rollout of Obama's health care law next year drives spending increases in the Health and Human Services budget, but the president is also proposing to trim Medicare costs as he tries to draw Republicans into negotiations to reduce government red ink.
Ninety percent of HHS spending is "mandatory," meaning it goes for benefit programs like Medicare and Medicaid that aren't subject to routine annual budgeting in Congress.
Under Obama's health care law, Medicaid spending will rise significantly next year as the program is opened up to low-income people who aren't currently eligible, mainly adults with no children living at home. Middle-class people who don't get coverage on the jobs will be eligible for tax credits to help them buy private health insurance, but those costs aren't reflected in the HHS budget under government accounting practices.
Obama is proposing to cut Medicare spending about $400 billion over 10 years from currently projected levels. In percentage terms, that translates into a single-digit trim for the giant health program that serves seniors and disabled people. The biggest chunk, more than $130 billion, would come from drug company rebates, including a new proposal that speeds up closing Medicare's prescription drug coverage gap.
Upper middle-class and well-to-do seniors would face higher monthly premiums for outpatient care and prescriptions, an idea that Obama has floated before and that also has Republican support. Newly joining beneficiaries would pay somewhat more for home health care and for outpatient services.