The House this week voted on a bill (HR 1954) to increase the nation’s debt limit so as to allow the country to continue borrowing money without going into default. The bill overwhelmingly failed on a bipartisan vote of 97-318. The vote was widely seen as a move to build pressure for linking the debt limit increase with accompanying budget savings.

 

Negotiations over proposals to reduce federal spending continue, with Vice President Joe Biden leading talks among key Republicans and Democrats from both chambers. President Obama this week joined the effort, holding separate talks with House Republicans and House Democrats. A consistent sticking point in negotiations is Republicans’ and Democrats’ failure to agree over what means should be used to produce budget savings: Republicans have consistently advocated for trillions of dollars in cuts to federal spending, including major cuts to entitlement programs; while Democrats have urged combining spending cuts with revenue raising initiatives.

 

U.S. Treasury Secretary Tim Geithner has warned that Congress must enact a debt limit increase by Aug. 2 to prevent the nation from going into default. Although House Speaker John Boehner has urged Congress to reach a solution by the end of June, other fiscal conservatives have questioned the need for such quick action. 23 Republican Senators last week sent a letter to President Obama urging him to develop a contingency plan for a 2012 budget that does not include any borrowing authority. Meanwhile, other Republican leaders have written a letter warning Geithner that in the absence of a deal before Aug. 2, he may have to resort to even further extraordinary measures to keep the government solvent. 

 

The unfolding debt limit debate – particularly the question of whether and how deeply to cut entitlement programs – will have a profound impact on Medicaid and other programs that fund safety net addictions and mental health services. The National Council encourages all of our members to attend Hill Day, July 19-20, to speak up for the importance of these programs and fight to protect funding for behavioral health. See more details below.

 

 

 

As Congress continues to debate both the debt ceiling increase and the Fiscal Year 2012 budget, several proposed methods of reducing federal spending could have a substantial impact on the future of the program. Behavioral health providers should be aware of the ripple effect that these proposals – often couched only in terms of fiscal responsibility – may have on Medicaid.

 

Global Spending Cap: The notion of a global spending cap has been promoted by fiscal conservatives as a long-term solution to reducing federal spending. Under this scenario, both discretionary programs (such as the Mental Health Block Grant and Substance Abuse Prevention and Treatment Block Grant) and entitlement programs (like Medicaid) would undergo steep cuts to bring total federal spending to within a certain percentage of Gross Domestic Product. In future years, if spending grew above this limit, automatic, mandatory, across-the-board cuts would be imposed on all federal programs, including Medicaid. This scenario would likely force Medicaid to be converted to a block grant, since the program as currently designed could not support such funding reductions.

 

Health Spending Caps or Entitlement Spending Caps: Proposals to set a cap only on federal health spending or only on entitlement programs could have the same effect on Medicaid as a global spending cap: mandatory reductions to program funding and the potential for Medicaid to be converted to a block grant.

 

Medicaid Maintenance of Effort Repeal: This proposal, suggested both as stand-alone legislation and as a rider to the debt limit bill, would repeal the requirement under health reform that states maintain 2010 eligibility levels until 2014, when the Medicaid expansion and state health insurance exchanges take effect. Given the current budget shortfalls many states are facing, a MOE repeal would likely result in 300,000 Americans losing Medicaid coverage, according to a recent report.

 

Current Status of these Proposals: Many of the negotiations on the budget are taking place in secret, meaning that information about how Medicaid fares in any compromise deal may not be available until the deal is announced. At this point, it appears likely that the debt ceiling debate will include tens of billions of dollars – if not more – in spending cuts, and Medicaid is a likely target. Support for a MOE repeal appears to be growing in both the House and the Senate, and a vote on the proposal could come as soon as this month.

 

What You Can Do to Fight for Medicaid: You can write to your legislators today about opposing budget cuts to safety net programs by clicking this link. The National Council will use the Public Policy Update and our Action Alert network over the coming weeks to notify members of additional opportunities to contact your legislators in support of Medicaid. If you have not already subscribed to our Action Alerts, we encourage you to do so. In addition, we strongly encourage all members to attend Hill Day in Washington, DC, July 19-20, where you’ll have the opportunity to speak to your legislators and their staff face-to-face about the impact that cuts to Medicaid would have on you, your community, and the individuals you serve. The National Council is working hard in Washington to fight against these proposed cuts to Medicaid – but it is communications from constituents like you that typically can have the most sway over legislators’ votes.

 

 

 

The U.S. Department of Health and Human Services has announced new steps to reduce premiums and make it easier for Americans to enroll in the Pre-Existing Condition Insurance Plan, which serves as a bridge to 2014 when insurers will no longer be allowed to deny coverage to people with any pre-existing condition. Premiums for the plan will drop as much as 40 percent in 18 states, and eligibility standards will be eased in 23 States and the District of Columbia. Click here to learn more details about the changes to the Pre-Existing Condition Insurance Plan in your state. 

 

 

 

Have you ever felt that your opinions don’t impact federal policymaking? Actually, constituent advocacy is one of the most powerful ways to make a difference in the halls of Congress! Come to Washington, D.C. for Hill Day 2011, and take advantage of our workshops designed to help you be a successful advocate.

 

At our 2011 Public Policy Institute and Hill Day, the National Council is offering workshops that will help you learn how to successfully communicate your priorities to your elected officials. Our policy experts will teach strategies for influencing your federal representatives, provide information on how to prepare for your Hill visits, and coach you through mock meeting scenarios.

 

If you attended a session in 2010, join our advanced workshop for experienced advocates. If you’re a first-time Hill Day attendee – or if you just want more practice, come to our workshop on the basics of meeting with your elected officials. Stay tuned to the Hill Day page of our website for more details about these workshops as they become available.

 

In addition to these workshops, you can participate in our annual letter writing campaign to bring the voices of your communities to Washington. Stories from constituents back home have a powerful effect on public policy. Help build momentum for strong behavioral health policies by downloading our letter form, getting as many people as you can to fill in their stories, and returning the letters to Rebecca Farley at the National Council. We’ll  make sure all the letters get delivered to your elected officials on Hill Day. Click here to get started!

 

Registration for Hill Day is free and open to all members. Register today, and start setting up your July 20th appointments with your Senators, Representative, and the Washington branch of your Governor’s office!

 

 

 

Senator Debbie Stabenow this week is circulating a Dear Colleague letter that urges the Appropriations committee to provide a $14 million increase to the Mental Health Block Grant (MHBG) in the 2012 budget. If you have not already done so, please show your support for community mental health services by contacting your Senators and asking them to sign on to this letter!

 

Senator Stabenow’s letter will help build momentum for a block grant increase by showing Appropriations Committee members the strong level of support among their colleagues for a MHBG increase. Please take action today and urge your Senators to sign on!