Jackie Judd talks with KHN's Mary Agnes Carey about the latest in talks around the "super committee's" efforts to cut the deficit. Advocates and lawmakers are busy whispering what health programs should be shielded from cuts and which should be on the chopping block.
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JACKIE JUDD: Good day, this is Health On The Hill, I’m Jackie Judd. On Capitol Hill, the "super committee" continues its work, heading towards a Nov. 23 deadline. If the committee, and then the full Congress, do not approve at least $1.2 trillion in spending cuts over a decade, automatic cuts will go into effect in 2013 for many government programs. KHN Senior Correspondent Mary Agnes Carey is following the deliberations. She joins us. Good morning.
MARY AGNES CAREY: Good morning.
JACKIE JUDD: You’re following them as best as possible, but most of the deliberations are taking place in private. What have you been able to find out about the stage of these negotiations. Where are they?
MARY AGNES CAREY: They seem to be considering everything. Everything is on the table. Patty Murray, who is one of the co-chairs has said that repeatedly. A lot of people are looking to the fact that members are meeting behind closed doors. We’re not seeing a lot of leaks. There’s not a lot of paper floating around. No one appears to be storming out.
There's a new tone of seriousness with the super committee. The fact that they have stepped up the pace in the last few weeks. That they are meeting behind closed doors – not everybody likes that, mind you – but they interpret that as a positive sign that perhaps the super committee is on their way to getting some kind of a deal.
JACKIE JUDD: How are special interest groups, particularly health care concerns, how are they getting their messages into the committee about what they want to see? Petitioners in a way.
MARY AGNES CAREY: Exactly. Many are sending letters to the committee, which they are releasing to the press and to the public. People looking at a variety of things: They want Medicare beneficiaries protected from having to pay more. There's a lot of push to protect the Medicaid program, not to have any more cuts. Physicians and many members of Congress want a long-term fix to something called the sustainable growth rate, this is that Medicare physician payment formula we talk so much about.
JACKIE JUDD: The "doc fix."
MARY AGNES CAREY: The doc fix. Instead of having to rush a fix through at the end of this year to stop a potential cut, couldn’t we get a long-term solution? The big problem there, of course, is the money: $300 billion over the next decade.
There are folks that say, why don't you let Medicare negotiate prescription drug prices for beneficiaries instead of leaving it to the private sector? And, of course, there’s opposition to that idea. But there’s no shortage of ideas, not only being sent to the super committee, but also from all these commissions we’ve had over the last year or so that have tried to find ways to reduce the deficit.
JACKIE JUDD: Is there any consensus in the health care community about whether it would be more advantageous for the big spending or entitlement programs, more advantageous for the committee to fail so the automatic cuts would then go into effect?
MARY AGNES CAREY: One thing that's pleasing about the automatic cuts, also known as sequestration, is that Medicaid would be protected and Medicare would be shielded at 2 percent, and that’s only cuts for providers. So there are a lot of people in the health care community that say, perhaps sequestration is the better deal because of those two protections.
But there are also other health care programs that may not fall into that, don’t fall into that protection that people are worried about cuts there.
JACKIE JUDD: We should say that it's not an either-or. The super committee can decide to find cuts of, let's say $500 billion. Congress, in theory, could approve. And then the rest of the spending cuts would be done in the sequestration process.
MARY AGNES CAREY: That's exactly right. They don't have to go for a whole $1.2 trillion. Let's say they get the amount that you suggested. The remaining of that would be up to sequestration. Fifty percent of that amount would have to come from defense programs, 50 percent from non-defense program. But they’re across-the-board cuts. This is problematic for people, because at that point, no one can get in and change that across-the-board figure. So if you lessen the amount, that would give some people relief, but there’s still concern about an across-the-board cut for all these program that are not protected.
JACKIE JUDD: Mary Agnes, a final question. You spend more time on Capitol Hill than most people I know. But it seems to me that a lot of the debate, the political quarrelling that we were hearing prior to the creation of the super committee, about repeal and replace, about the impact of the Afforable Care Act, the reform law, has been quieted.
Is all action, all attention really focused on this one body?
MARY AGNES CAREY: Quite a bit of attention is focused on this super committee, and I think with good reason. Congress right now has a very low approval rating from the public. They want to see Congress act to reduce the deficit, reduce federal spending, which could improve the economy. There is a lot of focus there. There are a lot of lawmakers that want, perhaps either changes in the tax code, or changes in entitlements – there’s that ongoing tension between the Democrats and the Republicans over those very issues.
There are a lot of people watching the super committee as a microcosm of Congress. Can they produce something that could work for people? Could they work together to bridge these partisan divides that have really stalled a lot of action in Congress this year? Focus remains on the super committee. Whether or not they can overcome these ideological, partisan differences is unknown. A lot of lawmakers are concerned about having to vote on a product that can’t be amended. They’re a little concerned about these closed-door hearings. But there’s a lot of attention, a lot of focus, probably with good reason for the super committee.
JACKIE JUDD: More later, I’m sure. Mary Agnes Carey of Kaiser Health News, thank you.
MARY AGNES CAREY: Thank you.