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Medicare and the Budget Control Act’s Joint Select Committee

Creating Spending Reductions for the Next Decade?

By Children’s Home Society of Florida Foundation

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Under the compromise between President Obama and leaders of the House and Senate, the Budget Control Act of 2011 created spending reductions of over $900 billion during the next decade. The bill also requires leaders of the House and Senate to appoint members to a Joint Select Committee. The committee has three Republican, three Democratic Senators, three Republican and three Democratic Representatives.

House and Senate leaders have now appointed the committee members. The 12 committee members are tasked with creating a $1.5 trillion budget solution by Thanksgiving. Their bill will be voted on without amendments by December 23, 2011.

If the committee is not able to develop and pass a bill by Dec. 23, there will be $1.2 trillion in budget cuts. Half of the cuts will come from the Department of Defense and one-half will be reductions in payments to Medicare providers.

Majority Leader Harry Reid (D-NV) appointed three Senators. The Co-Chair of the Joint Select Committee will be Sen. Patty Murray (D-WA). His other two appointees are Sen. John Kerry (D-MA) and Sen. Max Baucus (D-MT). Sen. Kerry is Chair of the Senate Foreign Relations Committee and Sen. Baucus is Chair of the Senate Finance Committee.

Republican Leader Mitch McConnell (R-KY) appointed Sen. John Kyl (R-AZ), Sen. Pat Toomey (R-PA) and Sen. Rob Portman (R-OH). Sen. Kyl is the Republican Whip and a senior member of the Finance Committee. Sen. Toomey is a member of the Budget Committee. Sen. Portman was previously Director of the Office of Management and Budget.

Speaker John Boehner (R-OH) appointed Rep. Jeb Hensarling (R-TX) as Co-Chair of the committee. His other appointments are Rep. Dave Camp (R-MI) and Rep. Fred Upton (R-MI). Rep. Camp is Chairman of the Ways and Means Committee and Rep. Upton chairs the Energy and Commerce Committee.

Democratic Leader Nancy Pelosi (D-CA) appointed Rep. James Clyburn (D-SC), House Ways and Means Member Xavier Becerra (D-CA) and Budget Committee Member Chris Van Hollen (D-MD).

The Joint Select Committee is expected to initiate meetings in September after Congress returns from the August recess.

Editor’s Note: There will undoubtedly be a spirited debate. All of the twelve committee members will want to avoid drastic budget cuts for the Department of Defense or Medicare providers. The group will need to discuss potential cuts in discretionary expenditures, defense and entitlements. With the appointments of key taxwriters Baucus and Camp, it is clear that taxes will also be a part of the discussion. Whether or not there are tax increases as part of the budget solution remains to be seen.


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12 Responses

  1. Health sector picks its deficit-cutting poison

    The default 2 percent cut to Medicare payments that would kick in if the debt-cutting supercommittee can’t strike a deal would “most likely be a welcome relief to most major players in the health care debate,” Bill Clinton’s former senior healthcare adviser Chris Jennings just wrote in the New England Journal of Medicine.


    And, The Philadelphia Inquirer wonders why New York’s healthcare fraud prosecutor was fired.




  2. Both Parties Seek Job Growth

    President Obama will address a joint session of Congress the evening of September 8th. He is expected to speak on strategies for job creation. While the specifics have not yet been released, it’s expected that he will discuss a potential extension of the reduced payroll tax and a program to complete various infrastructure projects.

    The presentation comes following a very weak jobs report for August. Non-farm payrolls were unchanged during the month of August. Economists had expected that there would be a gain of 53,000 jobs. However, with the financial uncertainty and significant decline in stock markets during August, employers were unwilling to increase their number of employees. In addition, consumers are concerned about the economy. As a result, they are being financially careful and paying down debt.

    House Majority Leader Eric Cantor (R-VA) published his “upcoming jobs agenda” on August 28. He suggested that there are a number of ways to enhance job creation.

    His first suggestion is to repeal various “job-destroying” regulations. This could include a hold or revision of various regulations by the Environmental Protection Agency, the National Labor Relations Board or reducing mandates for healthcare plans.

    Leader Cantor also proposes a 20% of income deduction for small businesses. If this were to pass, small businesses would be taxed on 80% of income, rather than the present 100%. Mr. Cantor believes that this would encourage job growth in small businesses.

    Editor’s Note: It is certainly positive that both parties are seeking new ways to increase employment. All agree that the current unemployment rate of 9.1% is too high and has existed for too long. The consensus is building that Congress needs to take additional action to increase employment.

    Source: By Children’s Home Society of Florida Foundation


  3. Ideological foes unite to propose health spending cuts

    The National Taxpayers Union and the consumer advocates at the U.S. Public Interest Research Group released a joint list of recommendations for the deficit supercommittee, a clear sign that the nation’s fiscal woes are forcing ideological foes to seek common ground.




  4. Tax Changes in America Jobs Act of 2011

    Following his speech to a joint session of Congress, President Obama introduced provisions of the American Jobs Act of 2011. The $447 billion bill is designed to increase employment and have a positive impact on the economy.

    A major feature of the plan is to reduce employees’ Social Security payroll taxes in 2011 from 6.2% to 3.1%. Employers would also receive the same reduction on the first $5 million in employee payrolls.

    The American Jobs Act also includes tax credits for hiring injured veterans, long-term unemployed workers and “wounded warriors.” Businesses would be permitted to expense 100% of most acquired property and there would be grants for infrastructure and other purposes.

    The Obama administration this week released its proposed methods for offsetting the $447 billion cost. Approximately $400 billion of new revenue will come from reducing itemized deductions for upper-income Americans. Those taxpayers in the 33% and 35% tax brackets would have reduced deduction benefits for state and local taxes, mortgage interest and charitable deductions. Even though they pay tax at the higher brackets, their tax savings from these deductions will be limited to the 28% bracket under the White House proposal.

    House Majority Leader Eric Cantor (R-VA) responded to the American Jobs Act on September 13. He stated, “I will say that there certainly were areas that the President laid out that I believe we can work on together.” He indicated that the House and the President had areas of agreement on tax relief for small businesses. He also believed that they could agree to reduce regulations, particularly for infrastructure projects.

    However, Leader Cantor was quite concerned about the impact of reducing the deduction value of charitable gifts for upper-income taxpayers. He stated that the White House “tax proposals are going to impose taxes on charitable contributions and in fact impact at least 40% of tax-deductible charitable contributions. The question is why would we want to put an impediment in the way of the charities accessing funding when the charities are the ones out there helping people in need right now?”

    Editor’s Note: The American Jobs Act will now enter the legislative process in the House and Senate. It is also likely to be considered by the Joint Select Committee on Deficit Reduction.

    Source: By Children’s Home Society of Florida Foundation


  5. Proposed Growth and Deficit Plan

    Over 150 Associations joined together to send a letter to the Supercommittee known as the Joint Select Committee on Deficit Reduction. The associations urged the Supercommittee to consider a multi-year growth and deficit plan that would be much larger than the proposed $1.2 to $1.5 trillion plan in their mandate.

    The Associations include contractors, bakers, financial services, lighting, trucking and other businesses. In addition, many state and regional Chambers of Commerce joined in the letter.

    The proposed plan includes three basic sections. There should be a comprehensive reform of corporate and individual taxes, entitlement reform that recognizes the entry of 70 million baby boomers into the system and a strategy to stabilize debt.

    Tax reform could include both corporate and individual taxes. America’s “largest trading partners – Canada, Great Britain and Japan – have all taken steps to become more competitive.” The Associations recommend that the tax reform create policies that would encourage greater competitiveness that leads to higher employment. A better tax system could lead to “economic growth to employ and re-employ millions of Americans.”

    With respect to entitlement reform, the Associations note that there will be millions of boomers who retire during the next decade. The reforms should secure the benefits of current entitlement recipients and must phase in other changes very gradually.

    Finally, they propose a multi-year growth and deficit reduction strategy. These changes should eventually stabilize the debt. A national debt that is stable may lead to substantial growth and higher levels of employment.

    Source: By Children’s Home Society of Florida Foundation


  6. Medical societies urge supercommittee to address medical liability

    Nearly 100 state and specialty medical societies are urging the Joint Select Committee on Deficit Reduction to include medical liability reforms in the legislative proposal it is due to release next month.




  7. Both Parties Lobby Supercommittee Members

    As the Joint Select Committee on Deficit Reduction continues its closed-door deliberations, both Democratic and Republican Members of Congress continue to advocate specific tax positions. The Supercommittee is tasked with finding a deficit solution of at least $1.2 trillion and hopefully $1.5 trillion. The November 23 deadline is rapidly approaching with the committee still seeking to find compromise solutions that reduce the deficit.

    On October 13 the Democratic members of the House Ways and Means Committee sent a letter to Joint Select Committee Co-Chairs Rep. Jeb Hensarling (R-TX) and Sen. Patty Murray (D-WA). The Democratic members stated, “Ultimately, the Joint Select Committee and the Congress must take a balanced approach if we are to truly address our deficit and debt.”

    Democratic members note that federal receipts for the past three years have been “about 15% of the economy.” This is the lowest level in the past six decades. In their view, the deficit reduction plan cannot be solved “through spending cuts alone.” They further observe that President Obama has published specific tax revenue proposals to assist the Joint Select Committee in their task.

    The three principles that should govern revenue increases in their view are “job creation, fairness and fiscal responsibility.”

    On October 13, most of the Republican members of the Senate Finance Committee released their proposal. They suggest that there be a revenue-neutral comprehensive tax reform. Individual tax rates would be reduced to three brackets and a substantial exemption. The top individual and corporate rates would both be 25%.

    Sen. John McCain (R-AZ) stated, “We need to create a simplified tax system to keep money in the hands of consumers.”

    Editor’s Note: As the Joint Select Committee continues to seek to create a compromise acceptable to at least seven of the 12 members, it is probable that both parties and the White House will continue to advocate their respective solutions. Given the substantial potential reductions for the Department of Defense and Medicare if the Supercommittee cannot craft an agreement, it still seems probable that there will be a bipartisan compromise by the November 23 deadline.

    Source: Children’s Home Society of Florida Foundation


  8. SGR Repeal and Healthcare Cuts Among Ideas Sent to Supercommittee

    Leading congressional lawmakers advised a debt reduction committee to enact a mix of health care cuts, including tighter prescription drug spending, but maintain many existing health programs.

    The Budget Control Act of 2011 — adopted in August to allow an increase in the nation’s debt ceiling — gave congressional committee leaders until Oct. 14 to submit their ideas to the Joint Select Committee on Deficit Reduction. The debt panel faces a November. 23rd deadline to approve at least $1.2 trillion in savings, which Congress must adopt by December 23rd. Otherwise, broad automatic cuts affecting Medicare and defense spending would kick in.

    Source: Douglas Trapp, AM News [10/24/11]


  9. Bipartisan duo lead opposition to super-committee tax on health benefits

    A Republican and a House Democrat who led the opposition to the healthcare reform law’s tax on high-cost health plans are spearheading a bipartisan letter urging the deficit-cutting super-committee to leave employer-sponsored plans alone.




  10. Supercommittee Fails to Reach Deal

    The co-chairs of the Joint Select Committee on Deficit Reduction announced Monday afternoon that the 12-member panel will not reach bipartisan agreement before its Nov. 23 deadline. This summer’s Budget Control Act tasked the supercommittee—composed of six Democrats and six Republicans—to identify ways to cut at least $1.2 trillion in federal spending over the next decade. If the committee failed to achieve this goal, the next step is likely sequestration, in which automatic cuts of $1.2 trillion—split between defense and domestic programs—would kick in starting in 2013. Medicare cuts would be capped at 2%.

    “Once again, Congress failed to stop the annual charade of scheduled Medicare physician payment cuts and short-term patches, which spends more taxpayer money to perpetuate a policy everyone agrees is fatally flawed,” Dr. Peter Carmel, president of the AMA, said in a statement. “A decade of uncertainty and repeated threats of steep cuts jeopardizes access to care for seniors and military families who rely on the Medicare and TRICARE programs,” he added. “TRICARE rates are tied to Medicare rates, so a 27% cut to Medicare means a 27% cut to TRICARE.”

    Source: Jessica Zigmond, Modern Healthcare [11/21/11]


  11. Congress Goes Back to Work

    Following the failure of the Supercommittee to agree on a deficit solution of $1.2 trillion, Congress departed for the Thanksgiving holiday. When Congress returns in December, it will continue to face the deficit issue.

    The Co-chairs of the Supercommittee are Rep. Jeb Hensarling (R-TX) and Sen. Patty Murray (D-WA). They issued a joint statement and noted, “Despite our inability to bridge the committee’s significant differences, we end this process united in our belief that the nation’s fiscal crisis must be addressed and that we cannot leave it for the next generation to solve. We remain hopeful that Congress can build on this committee’s work and can find a way to tackle this issue in a way that works for the American people and our economy.”

    Several moderate members of Congress also urged continued deficit reduction efforts. Senate Budget Committee Chair Kent Conrad (D-ND) indicated he was disappointed but that “The fiscal challenge remains and has to be dealt with. A balanced and fair package has to include both entitlement and tax reforms that lower spending and raise revenue.”

    A group of conservative Democrats in the House known as the Blue Dogs also expressed concern. Rep. Heath Shuler (D-NC) noted that there was “broad bicameral, bipartisan support the Supercommittee had from nearly 150 members of Congress to ‘go big’ and come up with a comprehensive, $4 trillion deficit reduction plan that puts our country on a long-term fiscally sustainable path.” The Blue Dogs have on numerous occasions discussed the importance of a major solution to the deficit challenges.

    Editor’s Note: Congress will again face the need to find a comprehensive deficit solution next year. The Bowles-Simpson fiscal committee and the Blue Dogs both agree that a solution should be approximately $4 trillion. This debate on the balance of tax increases and spending cuts to address the budget deficit solution will continue during 2012.

    Source: Children’s Home Society of Florida Foundation


  12. Debt Deadlock Helps Medicare … but for How Long?

    While many Americans view the debt deadlock in Washington as a national stumbling block, advocates for Social Security and Medicare saw it as a victory when the congressional supercommittee declared defeat last week. The programs they view as vital to the country’s safety net were spared immediate serious cuts when the committee failed to issue a plan. Yet experts warn that changes to Social Security, Medicare and Medicaid will have to be part of any solution to curtail the country’s $15 trillion debt.

    An earlier debt commission led by economist Alice Rivlin and former Sen. Pete Domenici, R-NM, concluded that the mounting costs of Medicare are “the principal driver of future federal deficits.” In roughly seven years, federal health care spending will outpace the costs of every other program, including Social Security, according to the Congressional Budget Office.

    Medicare is expected to become insolvent, meaning that its income can’t cover costs, in 2024, according to the latest report by its trustees.

    Source: Laura Green, Palm Beach Post [11/26/11]


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