While it seems like only yesterday that we all endured the debt-ceiling debate, it is already time to focus on the next major threat facing Medicaid. 

Today the “super committee”, which was created by the debt-ceiling deal, held its first meeting.  The committee is charged with finding at least $1.2 trillion in deficit savings through spending cuts and/or tax changes over the next 10 years.  They have until November 23rd to report out a bill or trigger automatic across-the-board cuts.  The automatic cuts or “sequester” would be split 50-50 between defense and non-defense spending.  The cuts would impact providers who accept  Medicare–not recipients– but Social Security and Medicaid would be exempted from the automatic cuts.

The big question on everyone’s mind is whether the committee will take a “balanced approach” and include revenues in the package or just look at cuts. Most Republican members of the super committee have publicly pledged to reject options that raise revenues, almost any plan approved by the panel, which raises the specter of extremely damaging cuts to Medicaid and funding needed to implement the Affordable Care Act. Health policy expert, Chris Jennings, provides an insightful look into these issues in a New England Journal of Medicine article. From the perspective of most health care advocates, automatic cuts would be preferable to a legislative package that would put Medicaid and the Affordable Care Act in greater jeopardy. However, it is important to keep in mind that there are many other public health programs, outside of Medicaid, that will be negatively impacted by a sequester, making the next few months a very difficult balance for all.   

Many have urged the powerful committee to conduct business in a transparent manner and to keep all proceedings open to the public.  However, at today’s organizational meeting, a rules package was unanimously approved which granted the panel the authority to go into closed-door session if a majority of members agree to do so.  

The committee has until November 23 to report a bill with its recommendations, which must then be passed by the House and Senate under special rules by December 23. The President must sign the bill by January 15 in order to avoid the automatic cuts.  That’s a pretty tight legislative schedule under regular procedure but the package the committee approves will be granted protection from amendments and filibusters and will only need a simple majority for passage.

Here is the schedule:

Sept. 13: First hearing of joint committee. CBO Director Doug Elmendorf will testify on “The History and Drivers of Our Nation’s Debt and Its Threats”.

Oct. 14: Deadline for standing committees to forward their recommendations to joint committee.

Nov. 23: Deadline for joint committee to vote on legislative proposals, with a 10-year deficit reduction goal of $1.5 trillion.

Dec. 2: Deadline for joint committee to formally report proposals.

Dec. 23: Deadline for House and Senate to vote on proposals, without amendment.

Jan. 15, 2012: Deadline for President to sign measure or across-the-board spending cuts will be triggered.

Jan. 2, 2013: If triggered, across-the-board cuts will take effect.