The House and Senate Committees had until the end of Friday, October 14 to submit their proposals for reducing the deficit to the Joint Select Committee on Deficit Reduction. The Joint Committee has received many recommendations from Congressional Committees as well as interest groups, advocates, and think tanks. It appears that most of the Committees did not submit recommendations from the full committees, opting instead to submit separate majority and minority recommendations.
House Democrats are urging the Committee to raise revenue, protect most programs from big cuts, and focus on job creation. Regarding health care, House Democrats’ recommendations came from the ranking members of the Ways and Means Committee; the Oversight and Government Reform Committee, and the Energy and Commerce Committee. All three called on the Joint Committee to maintain the basic promise of Medicare and Medicaid, to maintain the current Medicare eligibility age, and not to shift costs onto states or beneficiaries. They argued that such cost-shifting would transfer a financial burden to those who can least afford it and do nothing to reduce actual health care costs. The Democrats said that any health savings should be used to fix immediate Medicare problems, primarily by replacing the formula for reimbursing physicians who see Medicare patients. Although there is near-universal agreement that the formula needs to be replaced, the estimated cost of repealing it is $300 billion over 10 years and Democrats did not offer a detailed solution. The Democrats did say that money could be saved by the continued implementation of President Obama’s health care overhaul and by reducing waste, fraud, and abuse in government health care programs. Letters from ranking Democratic members in the House of Representatives are available.
Of note are recommendations that would restructure the Medicaid program. Senate Finance Committee Republicans offered their recommendations, urging the panel to avoid any tax increases while overhauling entitlement programs, including Social Security. For Medicaid, the Senate Finance Republicans recommended “modernization of the program using the successful welfare reform model of the 1990s with states and governors leading the way through: Implementing fiscal responsibility by giving states defined budgets and empowering states to implement solutions for their citizens by giving states flexibility to modernize eligibility determination; developing and implementing provider reimbursement systems that encourage value over volume of services; designing benefits that comport with private-sector coverage, encouraging healthy beneficiary behavior, and better managing chronic disease; providing long-term care benefits with approaches that promote cost-effectiveness and self-directed services; and partnering with the federal government in providing more coordinated care for beneficiaries eligible for both Medicare and Medicaid.”