As the projected debt ceiling deadline draws ever-closer, Congress and the Administration have dialed up their efforts to ‘get to yes’ on a possible deficit-reduction deal, moving negotiations up to the highest levels of leadership. Despite a number of conversations over the last couple of weeks between the President and minority and majority leaders in the Senate and House, there is still no public evidence of a deficit reduction package that will garner the votes needed to raise the debt ceiling. The President is scheduled to meet with leadership again this Thursday, and says negotiators must get together over the next two weeks to resolve differences and come to a deficit deal. On the heels of last week’s massive health center mobilization day, here at NACHC we continue to watch the debt negotiations closely, as talks dovetail with our two priority fronts: Appropriations and Medicaid.
The Medicaid Front
With negotiators trying to find between $2 and $4 trillion in total projected savings over the next 10-12 years, we’ve long heard that cuts to Medicaid have been under discussion. The President proposed $100 billion in Medicaid savings compromised of several components said to include proposals such as a “blended” FMAP (Federal Medical Assistance Percentage), the federal matching rate for programs including Medicaid and CHIP, and the elimination of provider taxes, although there are still very limited details about these proposals. Since the devil’s in the details, we’re watching the Medicaid pieces of the deficit reduction debate very closely to ensure health centers and their patients are protected, and that the Medicaid program does not absorb a disproportionate share of cuts or cuts that endanger beneficiary access to care.
The Appropriations Front
The House Appropriations process has been moving forward, keeping more or less on track with the schedule set out by Chairman Hal Rogers (R-KY). So far, the House has cleared three FY 2012 Appropriations bills – Homeland Security; Military Construction, Veterans Affairs, and Related Agencies; and Agriculture, Rural Development, Food and Drug Administration, and Related Agencies. Additionally, the full Appropriations Committee has approved three additional bills – Defense; Energy and Water Development, and Related Agencies; and Financial Services. As of this writing, the House Labor-Health and Human Services-Education (Labor-HHS-Education) Subcommittee still plans to take up its bill – which funds the Health Centers program – in late July, with full Committee consideration scheduled for the following week. However, we continue to hear about the possibility of the Labor-HHS-Education bill not moving through Committee until after the August recess when there will likely be a revised allocation, informed by the deficit deal and since full House consideration of the bill is not expected to occur until mid-September. The Senate Appropriations Committee unanimously approved its first appropriations bill – Military Construction, Veterans Affairs, and Related Agencies – just last week. The Senate is expected to continue to advance appropriations bills, despite the absence a budget resolution setting a discretionary spending limit. But no word on which bill will be considered next, though action on the Labor-HHS-Education bill is not expected soon.