April 8, 2011
2011
- December 16, 2011
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- October 28, 2011
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- October 7, 2011
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| April 8 , 2011 |
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Government Shutdown Imminent as Congress and the President Struggle to Reach a Spending Compromise
With a federal government shutdown now only hours away, there is no word as yet of a compromise on FY2011 spending between House and Senate leaders and the President. If Congress and the President do not reach an agreement by midnight tonight, the federal government will operate only essential services and programs. There is, however, still the possibility that a shutdown could be averted through passage of another temporary continuing resolution. The House passed a temporary measure earlier this week that would cut Fy2011 spending by $12 billion from current levels. The Senate has scheduled votes on this measure, signaling that enactment of this measure is a potential alternative in the event that an agreement is not reached by the deadline of midnight tonight. The impasse comes after weeks of negotiations on FY2011 spending levels, and after the House passed a FY201 spending bill containing $61 billion in cuts from FY2010 funding levels, which the Senate rejected.
The difference between the House and Senate is said to be very small, with only$38 billion in cuts still being debated, but at the bigger issue is policy riders that Conservative House members are pushing. These policy riders include a measure to defund EPA efforts to regulate greenhouse gases, and another measure that would eliminate federal funding for Planned Parenthood. It has not yet been revealed what programs are under consideration for the $38 billion in spending cuts. The House-passed FY2011 bill included an unprecedented 5.2% cut to the NIH. Earlier this week, the House passed another temporary continuing resolution to fund government programs for one week that would cut $12 billion from current spending bills. Federal agencies, including the NIH, are preparing for essential operations. While the government is shut down, the NIH Clinical Center in Bethesda will not accept new patients and clinical trials scheduled to being during this period will be delayed.
BUDGET
House Republicans Unveil Budget Plan
House Budget Committee Chairman Paul Ryan unveiled the House Republican budget proposal this week. The sweeping proposal includes significant changes in federal spending, taxation and entitlement policy, with the goal of reducing $6.2 trillion in federal spending over 10 years.
The plan makes major changes to the Medicare and Medicaid program, including:
- Turns Medicare into a voucher program. As people 54 and younger reach eligibility, they would be provided a federal voucher to purchase private health insurance. Federal voucher support would be means-tested, with wealthier seniors receiving less federal support. People who are currently 55 and older would continue to use the traditional Medicare fee for service system.
- Creates a 10 year SGR fix. The proposal creates a deficit-neutral reserve fund to pay for the estimated $300 billion needed to address the SGR fix. The term "deficit-neutral reserve fund" implies that the SGR fix will be paid for in yet-to-specified cuts to other programs.
- Turns the Medicaid program into a block grant to the states. The block grant funding would be indexed for inflation and population growth. The federal eligibility standard would be removed and states would have significantly more flexibility to make revisions to the Medicaid program.
CLEAN AIR
EPA Survives Senate Votes; House Strips EPA authority
As part of the Small Business Jobs bill, the Senate defeated a series of amendments to strip or restrict EPA's authority to regulate climate change emissions. The key vote was on an amendment offered by Sen. Mitch McConnell (R-KY) to permanently prohibit EPA from regulating, requiring public reporting of emissions or conducting research on climate change. The amendments required a supermajority of 60 votes to be adopted. The McConnell amednment failed by a vote of 50-50.
Votes were held on a series of other amendments that would have delayed or restricted EPA's authority on climate change including:
- Rockefeller Amendment - a 2 year delay of EPA's authority to regulate green house gas emissions. This amendment failed by a vote of 12-88.
- Stabenaw/Brown Amendment - a delay in implementing the stationary source greenhouse gas rule, exempting certain sources. This amendment failed by a vote of 7-93. Baucus Amendment - a delay in granting EPA authority, and a change in permitting process. This amendment failed by a vote of 7-93.
In related action, the House of Representatives passed legislation prohibiting EPA from developing regulations or any policy related to climate change along largely partisan lines. This is the second time the House passed legislation to strip EPA of its authority to regulation greenhouse gases. The bill passed by the House was identical to the McConnell amendment that was defeated in the Senate.
CLINICAL PRACTICE
The Senate passed legislation repealing the 1099 provision of the Affordable Care Act. The 1099 provision required all businesses to report any transaction of $600 or more to the IRS. The provision was included in the Affordable Care Act as a way to increase federal revenue to pay for healthcare reform. The 1099 provision generated significant opposition from wide range of sources, and there was broad bipartisan agreement to repeal the provision from the healthcare reform law.
Similar legislation was earlier passed by the House of Representatives and is expected to be signed by the President.
The Washington Letter is written by the American Thoracic Society government relations office and emailed to all ATS members living in the United States. The letter keeps clinicians, scientists, and patients abreast of legislative, judicial, and regulatory issues in pulmonary, critical care, and sleep medicine. Each week's edition is archived on the ATS Web site, www.thoracic.org. If you have any questions or one more information about becoming involved in advocacy, please contact the ATS Washington office at 202-296-9770.
