The Debt Deal - with Rep. Ed Markey

Last night I was one of about 30 people attending a meeting with Representative Ed Markey (D-MA) to discuss the Budget Control Act and its likely effect on health care.  It was an information exchange, as he presented how the Budget Control Act is slated to play out and then listened to our concerns as to how that will most likely affect health care, ourselves, and our constituents/clients.

The Debt Deal (Budget Control Act) Basics
Markey laid out the "Debt Deal" as having 3 major steps, with Step 1 already complete: passage by the House and Senate and President Obama's signature on the Bill last Monday, August 1, 2011.

Step 1 is designed to trim $917 Billion from the budget over 10 years through spending cuts and caps.  $350 Billion will come from defense with the remainder from discretionary funds, which could include health care areas except Medicare and Medicaid.

Step 2 is the Super Committee, comprised of 12 members: 6 Republicans and 6 Democrats -- divided evenly between House and Senate from each party.  These legislators must hammer out an agreement by November 23, 2011 that reduces the federal deficit by $1.2 - $1.5 Trillion over 10 years and Congress must then pass that agreement as a Bill by December 23, 2011.

• In this step, nothing is off the table as far as spending cuts or caps or measures to increase revenues. 
• The Super Committee must reach agreement - i.e., reach agreement by simple majority (7 yes votes). 
• If they reach an agreement, that agreement goes to Congress as a bill they must vote on with no options for changes, filibuster, or other political maneuvering.  A simple yes/no vote is required.  
• The Bill then goes to the President for signature, with Presidential veto possible but unlikely. 

Step 3 kicks in only if Step 2 fails totally -- i.e,. there is no agreement --, Congress fails to approve an agreement, the President vetoes the resulting Bill, or it fails to reduce the deficit enough*.  Step 3 triggers automatic cuts in spending that are basically 50/50 between defense and non-defense budget items. 

• Defense would be cut by approximately 9%; this could include cuts to the VA (Veterans Administration).
• Non-defense would be cut by approximately 8%; these non-defense cuts would include a $2.5B cut to NIH (National Institutes for Health), a $525M cut to NSF (National Science Foundation), and a 2% cut (approximately $20B) to Medicare providers.  Medicaid, Social Security, and Medicare benefits are exempt in Step 3. 

*Note that Step 3 would kick in, at a reduced level, if Step 2 results in passage of a Bill that is significantly less than the expected $1.2-$1.5 Trillion.  The cuts in Step 3 would be amounts that would bring the total deficit reduction to the $1.2-$1.5T.

Super Committee
The 12 legislators chosen for this high stakes poker game have a great deal of latitude in how they slash the budget to reach $1.2-$1.5 Trillion in deficit reduction.  Nothing is off the table, according to the rules of the game. That includes Medicare, Medicaid, and other programs that are actually protected in Steps 1 and 3.

This step also includes the possibility of revenue generation.  However, when half the Super Committee has already pledged no tax increases, that immediately ties the other half of the Committee's hands.  As Markey pointed out last night, GOP leadership excluded any Republican leaders from the Super Committee who had indicated they were open to raising taxes**. 

Response from Attendees
Attendees included some people from Cambridge Health Alliance, two different Alzheimer's advocacy groups, Mass Senior Action Council (they were out in force with half a dozen attendees -- great advocacy!), Hallmark Health, myself from Tri-CAP (also representing the HealthMINT Network and the Heritage Tenants Association), a Mass Elders advocacy group, individuals representing themselves and their family members, and state senators Pat Jehlan (D-Medford) and David Linsky (D-Natick) and a representative from sate Senator Katherine Clark (D-Malden).  Some groups were represented but I just cannot recall their names, so if were there and I missed you feel free to comment on this post and add that you were there!

Concerns included fears that:

• the automatic deficit reduction strategy would decimate essential health research and that will result in far-reaching future medical costs that will only increase our debt, 
• cuts to medicare providers will result in increased health costs to everyone else,
• no one seems to be talking about increasing revenues to offset the deficit
• the GOP is playing hardball while we're caving in and that has to stop
• it's not a negotiation if one side comes to the table refusing to consider other options (i.e., the "no tax increases" stand by the GOP),
• defense cuts might unfairly reduce VA benefits, and
• fear that those already slipping over the edge into an abyss of depression, job loss or pay cuts, housing loss, stress, mental health issues, etc. are not finding any relief and this Bill makes that worse. 

Markey then asked us each to tell him which Step (2 or 3) we would "vote" for so he can go back to the House and talk to his colleagues.  Nineteen (19) participants voted for Option 2 as preferable over the seven (7) votes for Option 3.  He also reminded us that every legislator needs to hear from all of us.  If we want to have a say in the final outcome, we must mobilize and make our voices heard on the subject.  The Tea Party has been very organized and goal-driven; we must do so also if we don't want our worst fears to come to fruition. 

Congressman Markey, we appreciate your invitation for us to meet with you and give you our input on this critical matter and to represent our constituents' needs.

Additional information sources for this morning's article:

• "Quick Summary" of the bill by Keith Hennessey
• "The Debt super committee: who will serve on it,"by Paul Kane, Washington Post
• **"Deficit 'super committee' reflects party leadership," by Lisa Mascaro, Los Angeles Times
• Numerous articles on economics and politics by Paul Krugman, NY Times

Disclaimer:   I attended this meeting as part of my paid job with Tri-CAP and thus "reported" on it in this format.  My views do not necessarily reflect the views of Tri-CAP.