Published by: Shawn Gremminger on 12/6/2010 11:12:07 AM
On Wednesday morning, the National Commission on Fiscal Responsibility and Reform released its final proposal to significantly reduce the nation's budget deficit. The comprehensive proposal would make big changes to nearly every "sacred cow" in the federal budget including ending popular tax deduction, cuts to domestic and defense discretionary spending and very large cuts to the three big entitlement programs: Medicare, Medicaid and Social Security. One thing that the Commission proposal doesn't include: Cuts to Disproportionate Share Hospital (DSH) funding.
Keeping DSH off the chopping was no small feat by NAPH and public hospitals. Just three weeks ago, the commission's co-chairs proposed accelerating cuts to DSH currently included in law as part of the Affordable Care Act. By acting swiftly and decisively, NAPH and our hospitals were able to convince the Commission's leaders to reverse course and not recommend these cuts. Our argument was a straightforward one: the Affordable Care Act reduces DSH payments in conjunction with a significant expansion in health care coverage to those who otherwise would be uninsured. The DSH cuts are phased in slowly and only become significant after the coverage expansion has taken effect. NAPH remains very concerned that the DSH reductions included in the Affordable Care Act are already too large and we look foreword to making our case before those cuts go into effect. But the cuts originally proposed by the commission's co-chairs had no basis in changes to coverage or payment and would be extremely harmful to vulnerable and low-income patients seeking care at our nation's safety net hospitals.
Unfortunately, while we were successful at protecting DSH from the chopping block for now, the proposal includes many other cuts that are deeply concerning to us. In particular, proposals to move all low-income Medicare beneficiaries to Medicaid managed care plans, slash Graduate Medical Education payments and eliminate the legitimate use of provider taxes to help fund the non-federal share of Medicaid would all potentially harm low-income people in the United States.
Today, members of the Commission will take a final vote on the recommendations as a whole. Since the proposal was released on Wednesday, we've contacted a number of undecided commissioners to note our happiness with the exclusion of DSH cuts, but reminding them of the other cuts which we believe would be damaging. Once again, our message is straightforward: We believe deficit reduction is critical to our nation's economic future, but we shouldn't balance the federal government's budget on the back of our country's most vulnerable residents.
We don't know what parts of the Commission's proposal Congress might choose to take up next year. Incoming Budget Committee Chair and Fiscal Commission member Paul Ryan (R-WI) suggested that he plans to borrow significantly from the individual proposals. We look forward to working with Congressman Ryan and the rest of Congress on proposals to reduce the deficit by actually reducing health care spending and we are ready to fight any proposals which would harm our hospitals and the millions of patients they serve.