U.S. Treasury Secretary Timothy Geithner (Bloomberg News/Landov)
Political observers in Washington this week felt a sense of déjà vu in the wake of comments by House Speaker John Boehner (R-OH) about the national debt. One year ago, in May of 2011, Congress was hotly debating whether to raise the debt ceiling, with Republicans insisting that any increase to the national debt be fully paid for with spending cuts, while Democrats sought an approach that mixed cuts with revenue increases. The parties eventually agreed on a compromise (the Budget Control Act), which raised the debt ceiling limit but also laid out a schedule of spending caps for the next 10 years and set in motion a special committee process whose failure ultimately triggered $1.2 billion in automatic spending cuts to begin in 2013.
Fast forward one year, to Treasury Secretary Timothy Geithner’s recent announcement that the U.S. will once again reach its borrowing limit near the end of 2012 – and Speaker Boehner’s response on Tuesday that any increase in the debt ceiling must be fully matched with “real spending cuts and reforms.” Democrats, in turn, instantly revived last year’s critiques that the fiscal hawks in Boehner’s caucus were holding the global economy hostage to their cost-cutting agenda.
The newest round of congressional sparring over the debt limit sheds light on what is likely to be a particularly complicated season for national fiscal policy. The end of 2012 marks not only the point at which the U.S. will once again reach its borrowing limit, but also the expiration of the Bush tax cuts and the launch of the automatic spending cuts outlined under the Budget Control Act. And the political pressures of the upcoming elections will only make resolving this trio of fiscal issues more difficult. Many experts say a comprehensive deal is unlikely until after the November elections. Nonetheless, Boehner announced on Tuesday that the House would vote before the elections on legislation to extend the Bush tax cuts and put in place a process for expedited passage of a broader tax overhaul in 2013.
Some lawmakers have said they expect Congress to pass a short-term fix that would give them several months or even a year to strike a long-term deal on deficit reduction, the Bush tax cuts, national tax policy more broadly, and the U.S. debt limit. As Sen. Lamar Alexander (R-TN) noted, “my guess is an extension is almost inevitable.” Yet, the extra breathing room may not help lawmakers reach a compromise if the next Congress remains as ideologically polarized as the current one. In fact, the convergence of these three fiscal issues – which has come about precisely because Congress repeatedly failed to find common ground on longer-term fixes for any of them – highlights the pitfalls of relying on legislative patches and extension bills to solve problems of major national importance.
The National Council will continue to keep you informed about the latest updates on the federal budget, spending cuts, and the debt limit. Please visit our blog to see our past coverage about the threats to healthcare and social services spending in the ongoing debates over the nation’s fiscal course.
The Supreme Court this year held hearings on one of the most historic cases in decades: a challenge by 26 states to the constitutionality of the Affordable Care Act. The Court’s decision will have ramifications far beyond President Obama’s signature healthcare achievement. And with a ruling widely expected to be issued during the last week in June, there’s no better time to visit Washington, DC to get briefed on what it means for the U.S. health system.
At the National Council’s 8th Annual Public Policy Institute and Hill Day, we’ll be bringing you up-to-the-minute news about the ACA case. Patricia A. Millett of the prestigious DC law firm Akin Gump will present a breakout workshop on June 25 entitled “Supreme Court: Implications of the Affordable Care Act Decision.” The session will cover the four major issues at stake in the case against the ACA, the possible decisions the Court might make on each, and the impact of those decisions on both the ACA and the nation’s healthcare system.
Patricia Millett heads Akin Gump’s Supreme Court practice and co-heads the firm’s national appellate practice. She has argued a total of 31 cases before the U.S. Supreme Court (the most of any woman in history) and approximately 35 in the courts of appeals. She has briefed scores of cases in the Supreme Court and appellate courts across the nation.
Join us at Hill Day to get expert insights from Ms. Millet on the ACA ruling! Click to register and book your hotel room.
You can also read our prior blog coverage on the ACA case by clicking here.
On Wednesday, May 9, 2012, the Department of Health and Human Services (HHS) released proposed language for implementing the Medicaid primary care rate increase under Section 1902(a)(13) of the Affordable Care Act (ACA). The purpose of the provision is to encourage physicians to participate in Medicaid, and thereby promote access to primary care services for current and new Medicaid beneficiaries to be served via coverage expansion in 2014. The proposed rule is intended to provide states with appropriate direction for implementing this provision within both managed care and fee-for-service delivery systems.
This fact sheet prepared by the Center for Health Care Strategies (CHCS) provides an initial overview of HHS’ planned regulatory approach and briefly outlines next steps for states. It was developed through Leveraging the Medicaid Primary Care Rate Increase, a national initiative made possible by The Commonwealth Fund, with additional support from the New York State Health Foundation. Look for further analyses and tools from CHCS in the future to help states and other Medicaid stakeholders prepare for the rate increase
Infosys Public Services surveyed health plans and provider organizations about their thoughts on key imperatives for health reform readiness in 2012. The results are displayed in this infographic (click to enlarge) – or, in this pdf summary.
As states continue to grapple with the effects of the recession, many have been forced to cut services. This documentary from Milestone in Pittsburgh, Pennsylvania, details the impact of transit cuts on people with disabilities. It shares the story of a group of individuals with mental illnesses and/or intellectual/developmental disabilities, and their fight to preserve their independent way of life.
Have you ever felt that political polarization in Congress makes it hard to get your message through? If you have, you’re not alone.
This year at the National Council’s Public Policy Institute and Hill Day, we are pleased to welcome the Honorable Gordon H. Smith as one of our keynote speakers. Senator Smith will tackle the question of how to work across party lines to raise the profile of mental health and addiction issues in Congress.
Senator Smith, a Republican from Oregon, served in the U.S. Senate from 1997-2009. During his time in office, he continually demonstrated his commitment to protecting our nation’s health care safety net by working with his Republican and Democratic colleagues to save and improve the Medicaid and SCHIP programs. He was also instrumental in enacting the 2008 Paul Wellstone-Pete Domenici Mental Health Parity and Addictions Equity Act, which prohibits the discriminatory treatment of mental health and addictions benefits in health insurance plans.
Senator Smith’s personal leadership was also critical in securing the passage of the Garrett Lee Smith Memorial Act, which is named in memory of his son. Throughout his tenure in the Senate, he was a constant and vocal advocate for helping states and communities develop the infrastructure needed to help prevent suicide. Senator Smith is President of the National Association of Broadcasters.
Working together, advocates can raise Congress’ awareness of our nation’s mental health and addiction treatment needs. And together, we can win bipartisan support for policies that support a strong behavioral health safety net.
House Speaker John Boehner (R-OH) and Senate Majority Leader Harry Reid (D-NV)
Today, the House approved legislation that would cut $315 billion from social programs in 2013. The legislation is House Republicans’ response to the $72 billion in cuts that are slated to go into effect in January 2013 under the terms of the Budget Control Act of 2011. That law tasked a special committee with reducing the deficit by $1.2 trillion – and upon its failure, triggered automatic cuts of the same amount spread out over the next ten years, split evenly between domestic and defense programs.
However, the GOP plan goes well beyond the cuts required by the BCA. It restores the $72 billion that would be cut in 2013 and then identifies $315 in new cuts elsewhere in the budget. A primary target for these new cuts is the Supplemental Nutrition Assistance Program (also known as food stamps), which would see a $38.5 billion reduction from tightening eligibility rules and returning benefits to pre-2009 levels. The bill also repeals the Social Services Block Grant, which is used to fund a wide variety of social support and human services programs around the country, including some programs that provide mental health services. Additional savings would come from requiring federal workers to pay more for their defined benefit pensions and capping damages and limiting attorney fees in medical malpractice lawsuits. [click to continue…]
The Department of Labor’s Employee Benefits Security Administration (EBSA) has posted a set of frequently asked questions and answers on implementation of the Mental Health Parity and Addiction Equity Act of 2008.
The FAQs address a variety of topics, including:
It is permissible for a health plan to define mental health coverage as consisting solely of inpatient care benefits?
Does my health plan violate MHPAEA because it uses a separate managed behavioral health organization to provide utilization review and other services with respect to mental health and/or substance abuse benefits (sometimes called a carve-out arrangement)?
How does MHPAEA interact with State mandates?
The FAQs clarify that if a plan covers mental health or substance use disorder benefits in one of the six coverage classifications under MHPAEA, the plan must provide coverage in all of the classifications in which medical/surgical benefits are available. [click to continue…]
This week, the Centers for Medicare and Medicaid Services announced the first 26 Health Care Innovation grants that have been awarded, including to two National [...]
The Department of Health and Human Services has released a proposed rule outlining the approach it intends to take in implementing a temporary Medicaid physician [...]
