GOP may press changes to Medi­care in debt ceil­ing, bud­get talks

Modern Healthcare - - THE WEEK AHEAD - —Shan­non Much­more

Con­gres­sional Repub­li­cans may in­ject con­tro­ver­sial health­care changes into the deal­mak­ing as the debt-ceil­ing dead­line looms on Nov. 3 and the con­tin­u­ing bud­get res­o­lu­tion is set to ex­pire on Dec. 11.

Sen­ate Ma­jor­ity Leader Mitch McCon­nell (R-Ky.) re­port­edly wants to limit Medi­care ben­e­fits to more-af­flu­ent se­niors and raise the pro­gram’s el­i­gi­bil­ity age in re­turn for in­creas­ing the bor­row­ing limit and fund­ing the gov­ern­ment. The White House has said it would not ac­cept those pro­pos­als in the cur­rent ne­go­ti­a­tions.

It’s un­clear whether GOP lead­ers will press such de­mands to the point of throw­ing the gov­ern­ment into de­fault or shut­ting it down, given the up­com­ing 2016 elec­tions. But a de­lay in reach­ing a bud­get deal could hurt health­care or­ga­ni­za­tions.

Un­der a gov­ern­ment shut­down, fed­eral health­care agen­cies such as the Na­tional In­sti­tutes of Health would stop op­er­at­ing un­til their ap­pro­pri­a­tions are ap­proved, said Joseph An­tos, a health pol­icy ex­pert at the con­ser­va­tive Amer­i­can En­ter­prise In­sti­tute. Ru­ral and safety net hos­pi­tals also would be hard hit.

Still, Ed­win Park, vice pres­i­dent for health pol­icy at the lib­eral Cen­ter on Bud­get and Pol­icy Pri­or­i­ties, said ne­go­ti­a­tions around re­mov­ing or ad­just­ing bud­get se­quester cuts could in­volve Medi­care cuts. He also noted that 30% of ben­e­fi­cia­ries will face a sharp in­crease in Part B pre­mi­ums if no con­gres­sional rem­edy is ap­proved.

De­spite the Dec. 11 dead­line, An­tos said he doesn’t ex­pect con­gres­sional talks to get se­ri­ous un­til af­ter the Thanks­giv­ing break, but be­lieves an agree­ment will be reached be­fore Christ­mas. “This is the pat­tern we’ve seen for a few years now,” he said. And he’s con­fi­dent the debt-ceil­ing hike will be ap­proved. “There’s very lit­tle ques­tion in my mind,” he said.


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