	Introduction

Federal law requires the President to submit an annual budget request to Congress no later than the first Monday in February. The budget informs Congress of the President's overall federal fiscal policy based on proposed spending levels, revenues, and deficit (or surplus) levels. The budget request lays out the President's relative priorities for federal programs, such as how much should be spent on defense, education, health, and other federal programs. The President's budget also may include legislative proposals for spending and tax policy changes. Although the President is not required to propose legislative changes for those parts of the budget that are governed by permanent law (i.e., mandatory spending), such changes generally are included in the budget. President Obama submitted his FY2016 budget request to Congress on February 2, 2015. The Centers for Medicare & Medicaid Services (CMS) is the division of the Department of Health & Human Services (HHS) responsible for administering Medicare, Medicaid, and the State Children's Health Insurance Program (CHIP). CMS also is responsible for administering the private health insurance programs established in the Patient Protection and Affordable Care Act (ACA; P.L. 111-148 , as amended). CMS is the largest purchaser of health care in the United States, with Medicare and federal Medicaid expenditures accounting for almost 30% of the total national health expenditures in 2013. This report summarizes the President's budget request for each of the following sections of the CMS budget: Medicare, Medicaid, program integrity, CHIP, state grants and demonstrations, private health insurance protections and programs, the Center for Medicare & Medicaid Innovation, and program management. Then, for each legislative proposal included in the President's budget, this report provides a description of current law and the President's proposal. At the end of each of these sections, a table summarizes the Administration's estimates of costs or savings associated with each legislative proposal. Budget Summary

The CMS budget includes both mandatory and discretionary spending. However, a vast majority of CMS spending is mandatory, such as Medicare benefit spending and grants to states for Medicaid. Total Net Outlays: With the Medicare physician payment adjustment, the estimated impact of the legislative proposals, and the estimated savings from program integrity activities ($0.9 billion), the President's budget estimates CMS's net outlays would be $970.8 billion in FY2016, which is an increase of $73.6 billion, or 8.2%, over the estimated net outlays for FY2015. The CMS budget is divided into the following sections: Medicare, Medicaid, program integrity, CHIP, state grants and demonstrations, private health insurance protections and programs, the Center for Medicare & Medicaid Innovation, and program management. The President's budget includes legislative proposals that would impact CHIP. Legislative Proposals

The President's FY2016 budget contains a number of proposals that would impact the CMS budget. Some of these proposals are program expansions, and others are designed to reduce federal spending.
Federal law requires the President to submit an annual budget request to Congress no later than the first Monday in February. The budget informs Congress of the President's overall federal fiscal policy based on proposed spending levels, revenues, and deficit (or surplus) levels. The budget request lays out the President's relative priorities for federal programs, such as how much should be spent on defense, education, health, and other federal programs. The President's budget also may include legislative proposals for spending and tax policy changes. While the President is not required to propose legislative changes for those parts of the budget that are governed by permanent law (i.e., mandatory spending), such changes generally are included in the budget. President Obama submitted his FY2016 budget request to Congress on February 2, 2015.
The Centers for Medicare & Medicaid Services (CMS) is the division of the Department of Health & Human Services (HHS) responsible for administering Medicare, Medicaid, and the State Children's Health Insurance Program (CHIP). CMS also is responsible for administering the private health insurance programs established in the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). CMS is the largest purchaser of health care in the United States, with expenditures from CMS programs accounting for almost 30% of the nation's health expenditures. In FY2016, CMS estimates that almost 126 million individuals will receive coverage through Medicare, Medicaid, and CHIP.
The CMS budget includes a mixture of both mandatory and discretionary spending. However, the vast majority of the CMS budget is mandatory spending, such as Medicare benefit spending and grants to states for Medicaid. In the President's FY2016 budget, proposed Medicare outlays make up 60% of the CMS budget and proposed Medicaid outlays comprise 36% of the CMS budget.
The CMS budget is divided into the following sections: Medicare, Medicaid, program integrity, CHIP, state grants and demonstrations, private health insurance protections and programs, the Center for Medicare & Medicaid Innovation, and program management. The President's FY2016 budget contains a number of legislative proposals that would affect the CMS budget. Some of these proposals are program expansions, and others are designed to reduce federal spending.
The President's proposed budget for CMS would be $970.8 billion in net mandatory and discretionary outlays for FY2016, which would be an increase of $73.6 billion, or 8.2%, over the estimated net outlays for FY2015. This estimate includes the cost of the Medicare physician payment adjustment ($8.8 billion), the net cost of legislative proposals ($5.4 billion), and the estimated savings from program integrity investments ($0.9 billion).
This report begins with summaries of each section of the CMS budget. Then, for each legislative proposal included in the President's budget, this report provides a description of current law and the President's legislative proposal. The President's budget includes legislative proposals for the following sections of CMS: Medicare, Medicaid, program integrity, CHIP, state grants and demonstrations, and program management. A table summarizing the Administration's estimates of the budgetary impact for each legislative proposal is at the end of each of these sections.