Public Health Initiatives at Risk if Debt Panel Does Not Reach Agreement
Federal funding for public health initiatives could drop significantly if members of the debt committee cannot agree on deficit-reduction proposals and instead allow automatic cuts to take effect, Kaiser Health News/Washington Post reports (Weber Serafini/Carey, Kaiser Health News/Washington Post, 10/16).
As part of the recent budget agreement, the 12-member panel -- also known as the "supercommittee" -- must develop and pass by the end of November $1.5 trillion in federal spending cuts over 10 years. Failure to do so would trigger a series of automatic across-the-board cuts. Medicaid would be exempt from those cuts, and Medicare would be protected from deep spending cuts (California Healthline, 10/14).
Many analysts have focused on the debt panel's expected cuts to entitlement programs, but public health advocates are cautioning that smaller programs are just as vulnerable and need protection from the automatic cuts.
Richard Deem, senior vice president of advocacy for the American Medical Association, said, "I don't know if a lot of people have appreciated how big a hit the discretionary health programs could take if there are automatic cuts," adding, "I think a lot of people are going to wake up to that too late."
Areas that would be affected by the automatic cuts to federal health funding include:
- Biomedical research;
- Foodborne illness and disease monitoring;
- Medical research; and
- Prevention programs for HIV/AIDS and other diseases.
Richard Kogan, a senior fellow at the Center on Budget and Policy Priorities, estimated that if the $1.2 trillion in automatic cuts take effect, funding for nondefense, discretionary programs would see reductions of almost 9% in 2013 (Kaiser Health News/Washington Post, 10/16).
Debt Panel Could Target Medigap Policies
The debt panel likely will consider overhauling Medigap coverage, private supplemental insurance plans purchased by Medicare beneficiaries, CQ Today reports.
Many Medigap plans cover the full cost of nearly all medical services not covered by traditional fee-for-service Medicare plans. Certain lawmakers and health care analysts are recommending that the federal government require Medigap policyholders to pay more for services so that they use them more judiciously. Estimates show the strategy could save Medicare as much as $53 billion over 10 years.
President Obama, members of Congress, the Medicare Payment Advisory Commission and fiscal experts have endorsed such changes. However, state regulators, advocates for seniors and insurers have criticized the strategy. State regulators said the plan would lead seniors to forgo needed medical care, which could increase Medicare costs later on. In addition, the Kaiser Family Foundation said assertions that limiting Medigap policies would influence behavior are "highly speculative" (Norman, CQ Today, 10/14).
GOP Senate Finance Committee Members Send Recommendations to Panel
Last week, Republicans on the Senate Finance Committee sent their deficit-reduction recommendations to the debt panel, CQ Today reports (Ethridge/Harrison, CQ Today, 10/14). The panel had asked House and Senate committees to submit their ideas by the end of last week (California Healthline, 10/14).
Their proposals include:
- Repealing the federal health reform law;
- Overhauling the medical malpractice system;
- Requiring high-income Medicare beneficiaries to pay more for services;
- Reconsidering design features for various Medicare plans;
- Turning Medicaid into a block grant system;
- Repealing the Medicaid maintenance of effort requirement so that each state can determine who is eligible for the program; and
- Finding additional Medicaid savings through new provider reimbursement systems, healthy behavior promotions, coordination of long-term care benefits and improved coordination of care for individuals who qualify for both Medicare and Medicaid (Ethridge/Harrison, CQ Today, 10/14).