As Fiscal Cliff Approaches, Cuts To Medicare, Medicaid Seem Likely.
From ASN Newsletter Kidney Daily, Nov 15, 2012: In a report on the ongoing fiscal cliff negotiations, The Hill (11/15, Baker, Viebeck) “Healthwatch” blog writes that President Obama made it clear in Wednesday’s news conference that he is “open to some type of entitlement reform,” but “which entitlements to cut, and where, is a hard — and changing — balancing act.” Several of the President’s allies spoke out to protect their various interests. One group, the liberal think tank Center for American Progress, “argued Wednesday that a deal to avert the fiscal cliff shouldn’t make major Medicaid cuts,” instead laying out a plan cutting $385 billion that mainly affected Medicare. However, also on Wednesday, AARP said that “Medicare should be off the table.”
The NPR (11/14) “Shots” blog reports on the Center for American Progress blueprint for cutting “hundreds of billions of dollars in entitlement spending without hurting middle- and low-income patients.” According to the article, “this new plan is notable not just for potential savings of a half-trillion dollars but for what some of those savings are.” The proposals “include many things that build on savings included in the Affordable Care Act, like cutting waste and encouraging more efficient care, as well as lowering payments to some providers.” More controversial suggestions include “asking wealthier Medicare beneficiaries to pay more out of pocket for their care,” and “limiting the tax-free status of health insurance for people who earn more than $250,000 a year.”
The New York Post (11/15) reports on the President’s vow to “find $340 billion in ‘savings'” in Medicare and Medicaid.
Obama May Be “Reticent” To Cut Medicaid Ahead Of Expansion. The Washington Post (11/15, Kliff) “Wonkblog” reports that the Supreme Court ruling which made the Affordable Care Act’s expansion of Medicaid optional may “have a silver lining for the entitlement program: The Obama administration could be reticent to cut Medicaid funding at the same time it’s trying to woo Republican governors into expanding the program.” According to Center for American Progress president Neera Tanden, major cuts to Medicaid could “undermine the strong case the administration is making each and every day for governors to…do the Medicaid expansion.”
The Hill (11/15, Baker) “Healthwatch” blog reports that in previous talks, Obama had backed “roughly $100 billion in Medicaid cuts, including a streamlined system for federal payments that would result in state governments taking on more of the funding burden.” Tanden says that a cut of that magnitude “has always been ill-advised, but it is more ill-advised today than it was a year ago.” CAP’s proposal includes just $10 billion of Medicaid cuts of a total of “$385 billion in healthcare spending.”
Many States Set To Make Medicaid Expansion Decision. Politico (11/15, Cheney, Smith) reports, “Clues about governors’ intentions for Medicaid expansion are beginning to seep out of tight-lipped state capitals, and it may be the start of a deluge.” Though several “have kept silent until now,” President Obama’s reelection, “combined with looming budget deadlines in all of the indecisive states, could force their hands.” Recently, “a handful of governors have indicated that they’ll use their state budget process to make a decision about Medicaid,” including Wyoming’s Gov. Matt Mead, Arizona’s Gov. Jan Brewer, and Montana Gov. Brian Schweitzer.