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Shared Emails From Advocacy Groups
As many of you know, a few key legislative proposals have placed Medicaid and other entitlement programs under fire. Earlier this month, the House approved Budget Committee Chairman Paul D. Ryan’s budget proposal, which included a provision to block grant Medicaid. In addition, Sen. McCaskill (D-MO) and Sen. Corker (R-TN) have proposed a bipartisan bill that aims to cap total federal spending and includes a “sequestration” process that would automatically make cuts if the cap was exceeded. Meanwhile, in the background looms another threat to Medicaid: across the board spending cuts. As the nation is about to hit the debt ceiling in early May, Republicans have pounced on the opportunity to leverage the debt ceiling bill for statutory spending caps, a balanced budget amendment and a two-thirds vote requirement for tax increases and debt limit increases.
These measures have been couched as neutral proposals to reduce the deficit, but they destructively cut entitlement and mandatory programs, like Medicaid. Inadequate federal funding for Medicaid translates into two possibilities: states shouldering the costs so that they can operate their Medicaid programs at the pre-cut level, or states cutting services and/or eligibility to fit within the reduced federal funding limit. Given today’s economic and political climate, it is more likely than not that states will opt for the second option and cut services.
These cuts would be devastating for the 30 million children and other vulnerable populations who rely on Medicaid. As advocates, we must make sure that we stand against any proposal to block grant, cap or cut Medicaid, and demand that the program remain fully funded.
Below is an article highlighting how the debt ceiling bill is being used as vehicle to cut funding for Medicaid. A report from the Center for Budget and Policy Priorities that explains how federal spending caps would be detrimental to entitlement programs is attached.
By Ezra Klein
The GOP is starting to get specific about what they’re going to demand in return for increasing the debt limit. House Majority Leader Eric Cantor says “major spending cuts or budget process reforms.” Karl Rove says “robust spending and deficit caps requiring rescissions and cuts if spending or deficits breach historic norms.” Note the focus on procedural change. Most in the GOP have concluded -- rightly, I think -- that the debt limit debate won’t offer the time or the space for a comprehensive deficit deal. So the question is how the budget process could be remade going forward such that the next comprehensive deficit deal -- or everything that happens in the absence of a comprehensive deficit deal -- is more to their liking.
Many on the Hill and in the White House expect that the debate will ultimately come down to two alternatives: the McCaskill-Corker spending cap, which would hold federal spending at 20.6 percent of GDP -- more than three percentage points lower than it is now, and much lower than it’s projected to be later -- and the deficit-reducing trigger that the president included in his budget.
I’ve spent some time looking at the McCaskill-Corker cap and haven’t come away impressed: it focuses on spending rather than debt, sets unrealistic targets given the aging of the population and rising health-care costs and poses a substantial risk of creating a strong incentive for politicians to shift their spending into the tax code, where it wouldn’t count against the cap. But the GOP has repeatedly shown itself more interested in attacking spending than in attacked debt (see “Bush tax cuts, the”) and would like budget strictures that lead to policy being driven through tax credits rather than through direct spending. In a way, the McCaskill-Corker cap forces an approach much like Paul Ryan’s, where the government saves money not by making reforms so much as by shedding obligations.
Obama’s deficit trigger works quite differently: it’s focused on how much debt we have rather than how much spending we’re doing, and when triggered, it makes automatic cuts in both a variety of categories of spending (though with some major exemptions, like Medicare and Social Security) and a variety of tax expenditures. In that way, one of its solutions to debt is to raise taxes, which is a reason Republicans don’t much like it. But a lot of the Democrats I speak to aren’t particularly confident about winning this debate. The case for a spending cap or balanced budget amendment is intuitive, while the case against, though ultimately more persuasive, is technical, relating to the need for macroeconomic flexibility, the dangers of prizing indirect spending over direct spending, etc. And as you’ll see in Wonkbook today, the GOP is organizing on this early, while Democrats are still milling around, and in some cases, finding themselves accidentally on the other side, as in Claire McCaskill’s support for a spending cap that she didn’t realize would get attached to the debt-ceiling debate.
Take action now in your state by meeting with your Rep!
Representative Paul Ryan is holding listening sessions next week and we want YOU to attend:
Tuesday, April 26:
- 9:30am at City Hall, 626 Geneva St, Lake Geneva, WI
- 11:00am at Village Hall, 108 East Main St, Twin Lakes, WI
- 1:30pm at Village Hall, 6969 236th Avenue, Paddock Lake, WI
- 3:00pm at Gateway Technical College, Madrigrano Auditorium, 3520 30th Avenue, Kenosha, WI
- 9:45 am at Village Hall, 123 North River St, Waterford, WI
- 11:15am at Franklin High School, Gymnasium, 8222 South 51st St, Franklin, WI *Attendees should park in LOWER/STUDENT LOT
- 1:30pm at Oak Creek Police Department, 301 West Ryan Road, Oak Creek, WI
- 3:00pm at Whitnall High School, Auditorium, 5000 South 116th Street, Greenfield, WI
- 10:30am,at Veterans Terrace (Liberty Hall), 589 Milwaukee Avenue, Burlington, WI
- 1:00pm, at Community State Bank, 1500 Main St, Union Grove, WI
- 2:15pm, at Village Hall, 2801 89th St, Sturtevant, WI
- 3:45pm, at Caesar Chavez Communtiy Center Gymnasium, 2221 Douglas Ave, Racine, WI
Posted: 22 Apr 2011 04:58 PM PDT
The Department of Health Services (DHS) announced yesterday that it will hold another town hall meeting to gather input on Medicaid budget cutting from consumers, community partners and providers. The meeting will be on Thursday, April 28th from 9:00 AM to 1:00 PM at the Liberty Hall Conference Center in Kimberly (800 Eisenhower Drive). Quoting from the DHS announcement: “Our Town Hall meeting is designed to collect ideas on efficiencies and cost-savings to meet this amount while improving overall consumer care, streamlining program delivery and stabilizing the program to ensure long-term sustainability.”
As we have noted before, the budget repair bill (which is still in legal limbo because of a court injunction) will give DHS the authority to make sweeping policy changes to achieve savings in the Medicaid and BadgerCare budgets. The Governor’s budget bill recommends the size of those cuts (roughly $500 million in state funding and more than $1 billion in combined state and federal funds), but once Act 10 becomes law the choices about how to make the cuts will be decided by DHS, not by the Legislature. A WCCF analysis summarizes the power that will be transferred to DHS by Act 10.
The department’s town hall meetings provide opportunities for public comment on what DHS should and shouldn’t do to achieve the spending reductions that the budget bill is likely to require. Individuals who are interested in testifying will have up to 3 minutes to share their ideas. If you can’t attend the latest forum or can’t cover all you might like to say in 3 minutes, you can submit your comments and recommendations electronically at http://bit.ly/dInAXp.
Although we don’t know specifically what DHS may be contemplating to achieve the cuts the Governor has recommended, Secretary Smith has shed at least a little light on some of the options that he appears to favor. Some of his ideas are outlined in his testimony before the Joint Finance Committee earlier this month. Courtesy of Wisconsin Eye, you can watch Smith’s testimony and the Q and A portion of his appearance by clicking here.
The Wisconsin Department of Health Services is having another Town Hall meeting for Wisconsinites to relate their concerns and ideas about the state’s Medical Assistance programs, this time in Kimberly, Wisconsin on Thursday, April 28. Please see the exact time and location below. DHS has said that they are mostly interested in cost-saving measures, but this is another great opportunity to speak up and let them know just how important and vital programs like BadgerCare Plus are to the families of Wisconsin!
Liberty Hall Conference Center
800 Eisenhower Drive
Kimberly, WI 54136
Meeting Rooms 1, 2, & 3
800 Eisenhower Drive
Kimberly, WI 54136
Meeting Rooms 1, 2, & 3
Thursday April 28, 2011
9:00 A.M. - 1:00 P.M.
9:00 A.M. - 1:00 P.M.
Please see this announcement for more details: http://www.dhs.wisconsin.gov/news/PressReleases/2011/042111.htm
Can’t make it to the meeting? DHS is also collecting feedback online: http://4.selectsurvey.net/dhs/TakeSurvey.aspx?SurveyID=74M18p9M
Medicaid's Role in the Health Benefits Exchange: A Road Map for States
National Academy for State Health Policy
Bachrach, Deborah; Patricia Boozang; Melinda J. Dutton
Examines issues for integrating Medicaid into the administration, operation, and coverage continuum of insurance exchanges. Discusses eligibility, enrollment, and outreach; contracting, standards, and requirements; benefits design; and infrastructure.National Academy for State Health Policy
Bachrach, Deborah; Patricia Boozang; Melinda J. Dutton
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