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Contact Congress on Drastic Budget Proposals Cuts to Medicaid, Medicare and Discretionary Spending In the Mix April 20, 2011 The budget proposal passed by the House of Representatives on April 14 would seriously undermine the Medicaid program, fundamentally change the way Medicare works and cap domestic discretionary spending at FY 2008 levels for the next five years. n4a is deeply concerned about the effect of this budget proposal on older adults and caregivers, particularly the provisions that could undermine the ability of millions of older adults to age in place with dignity, health and independence. We urge all AAAs and Title VI aging programs, as well as the local networks of leaders, providers and advocates you convene, to make clear to Congress that drastic cuts to the nation's safety net for frail and vulnerable older adults are not an appropriate starting point for the larger conversation about deficit reduction. Please share this Advocacy Alert widely and take action while Congress is on recess until the end of April. Background As previously reported by n4a (April 14 Legislative Update), the House FY 2012 budget resolution, often referred to as the "Ryan Plan" after House Budget Committee Chairman Paul Ryan (R-WI), includes an estimated cut of $1.4 billion in Medicaid by converting the program to a block grant and repealing the expansion of Medicaid under the Affordable Care Act (ACA). Not including the repeal of ACA funding, the proposal would reduce Medicaid funding for the next ten years by a total of $771 billion, or a reduction of about 35 percent. If enacted, states would have the burden of limiting their programs to deal with the reduced federal support. The reductions made by the state could take the form of curtailing covered services, capping enrollment and imposing high premiums and co-payments on beneficiaries. The Ryan Plan would also freeze non-security discretionary spending on programs such as the Older Americans Act, Section 202 and 811 housing, transportation and other social services programs at 2008 levels for the next five years. Additionally, the plan would covert Medicare into a voucher program for those now age 55 and younger (beginning in 2022) and increase Medicare eligibility to age 67. Under the redesigned program beneficiaries would be provided with a Medicare payment to buy insurance from a list of guaranteed private coverage options, similar to the Part C Medicare Advantage benefit. The non-partisan Congressional Budget Office (CBO) has predicted this proposal will increase the cost of health coverage for beneficiaries significantly. Budget Process Next Steps At this time there is no definite scenario for how and when Congress will consider the proposals built into the budget resolution. With the House and Senate highly unlikely to agree on a budget resolution, the next opportunity to address general spending caps is expected to be the federal debt ceiling legislation. Congress will have to consider legislation to raise the ceiling on the amount of debt the federal government can issue, currently set at $14.3 trillion. The federal government's debt is expected to reach that ceiling by May 16, and the Administration has stated that if the ceiling is not raised by July 18, it will be unable to make the payments on the existing debt. Unlike the budget resolution, the debt ceiling bill is "must pass" legislation. It is expected that fiscal conservatives will refuse to support legislation to raise the debt ceiling unless it is accompanied by legislation requiring limits on federal spending. Possible limits on spending could take many forms, but most likely they will be general in nature and detailed proposals on Medicaid, Medicare and other affected programs will likely be addressed in separate legislation. Meanwhile, President Obama is pushing for bipartisan negotiations between the Administration and Congress, with the goal of reaching an agreement on the overall budget by June. Advocacy Outlook The battle over cuts in Medicaid, Medicare and discretionary programs is likely to be prolonged, and involve a series of critical decisions and votes. It is important that the opponents of such proposals express their opposition early and often. Members of Congress need to be aware of the serious consequences to older adults and people with disabilities if drastic proposals are hastily adapted without thoughtful consideration of the short and long-term effects on the most vulnerable Americans. Action Requested: à Contact your Representatives and Senators to oppose proposals to block grant or cap spending under the Medicaid program. Use n4a's Talking Points for FY 2012 to make your case. (FY 2012 Budget Talking Points) Take the time to localize what these harmful cuts would mean for the older adults and people with disabilities in your state and community. STEP 1: Reach out to your Senators and Representatives. Attend any public events/town halls they are hosting and raise these issues and/or email their local and DC offices. (U.S. Capitol Switchboard = (202) 224-3121. Email = www.house.gov and www.senate.gov) STEP 2: Reach out to your Representatives and Senators to invite them to Older Americans Month events you are hosting during May. This is a great opportunity to educate your elected officials about key programs your agency operates and the critical services you provide to their constituents. STEP 3: Gather stories from your clients to share with legislators—putting faces on the facts is a powerful messaging tool. Share those stories and any feedback you receive as a result of your contacts with your Representatives and Senators with n4a policy staff. (www.n4a.org/advocacy/feedback/) STEP 4: Ask other advocates to do the same! Urge colleagues, advisory board members, volunteers and clients to make call and write emails to their legislators, as well.
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National Association of Area Agencies on Aging (n4a) |
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