By Chuck Ingoglia, Vice President, Public Policy
I am sure that most of us have had our fill of pundits offering opinions about why the elections went the way that they did, and what this means about the mood of the American people. You will not find any of that in this short piece. Instead, I will focus on what might the election mean for our community in terms of policy and funding.
I must begin this process with the acknowledgement that I do not own a crystal ball, and my ability to predict the future is cloudy at best. Therefore, I will confine myself to areas that have greater certainty than others…
Discretionary Spending Will Not Grow
Government agencies have already submitted Federal Fiscal Year 2012 budget figures to the Office of Management and Budget. Earlier this year, the President issued guidance to all federal agencies requested that each non security agency submit a budget request five percent below the discretionary total provided for that agency for FY 2012 than in the FY 2011 Budget.
It is safe to assume that discretionary programs in the Department of Health and Human Services, Justice, and Education will likely remain level or shrink.
The Increase in Federal Medicaid Payments will not be Extended
In light of revenue shortfalls in almost all of the States, the federal government provided a temporary increase in the Federal share of Medicaid spending that was scheduled to end on December 31, 2010 and was extended until June 30, 2011, albeit at a reduced rate. The combination of concern over federal spending, combined with changes in Congressional composition would suggest that chances of extending this federal support to states is unlikely to be extended again.
It will be Difficult to Repeal Healthcare Reform
The political realities of repealing a law make this scenario very unlikely, principally because of President Obama’s veto power. Another complication is that some parts of health care reform already in effect are pretty popular. Among them are provisions forcing insurers to cover children with pre-existing conditions and allowing parents to keep kids up to age 26 on their policies. That’s why congressional veterans predict that any potential rollbacks would be more piecemeal rather than a full-scale discard.
While we will likely see many proposals related to changing the healthcare reform law, most concerning to the addiction and mental health community will be efforts to scale back, or delay the Medicaid expansion scheduled for 2014. We have already discussed that federal discretionary funding will not be growing, and that additional federal Medicaid assistance is unlikely. The consequences of these actions is to put further pressure on STATE and COUNTY appropriations, further eroding addiction and mental health funding, especially for indigent populations.
There will also be efforts to take money away from funded programs, and the new Prevention and Wellness Fund is already seen as the prime target to steal from.
The National Council will continue to provide you with timely updates as the 112th Congress unfolds. Your continued advocacy will be essential as we move forward.