Congress Passes Budget Resolution; First Since 2009
The House and Senate have each passed a compromise budget resolution setting forth top-line spending and policy priorities for fiscal year 2016. This marks the first time since 2009 that both chambers have agreed to the same budget framework. Though the resolution does not have the force of law, it will guide Congress’ decisions on all elements of the budget, from health spending to entitlement program reforms.
Of critical importance for mental health and addiction providers, the final budget does not include earlier proposals that would have converted Medicaid into a block grant – a policy that could have disastrous results for safety net providers. Instead, the budget resolution directs the committees with jurisdiction over Medicaid to explore program changes that will enhance states’ “flexibility” in setting and implementing their own program rules. The block grant proposal is likely to resurface during this process, along with other harmful proposals such as imposing a per-capita cap on Medicaid spending. Republican leaders from the Senate Finance and Health, Education, Labor and Pensions Committees, along with the House Committee on Energy and Commerce, have already issued a letter to the Medicaid and CHIP Payment and Access Commission (MACPAC) asking for an analysis of the effect of these and other proposals on Medicaid.
The final budget agreement keeps in place the spending caps imposed under sequestration, a move that puts enormous pressure on Congress to cut discretionary programs such as those funded in the Substance Abuse and Mental Health Services Administration (SAMHSA) budget. The agreement calls for balancing the budget within nine years by cutting $5.3 trillion in federal spending. The effect of these caps will trickle down to line-items in the Labor-HHS appropriation bill and will make it difficult for legislators to preserve or increase funding for existing programs or find funding for newly proposed programs. The agreement also preserved the approximately $400 million Medicare cuts in President Obama’s budget proposal but shelved a House-led proposal to convert Medicare into a voucher-based purchasing system. Additionally, it included instructions for a special budget process known as “reconciliation” to effect changes to the Affordable Care Act, allowing Congress to bypass a Senate filibuster in an effort to repeal major parts of the law.
House and Senate appropriations committees have already turned to their work of drafting and approving the 12 annual appropriations bills that outline spending levels for all discretionary programs. Stay tuned to Capitol Connector for the latest news about the appropriations process.