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Report Required on Sequester Impacts

We may soon learn more about how the scheduled automatic budget cuts, or sequester, will affect federal programs. Yesterday, the Senate passed a House measure (HR 5872) giving the Obama administration 30 days to describe its plans for implementing the $1.2 trillion in automatic spending cuts scheduled to go into effect beginning in January. The measure had broad bi-partisan support, passing the Senate unanimously after having passed the House last week in a 414-2 vote. Republicans pushed the bill as a way to highlight what they say will be a devastating reduction to the military budget. Democrats also backed the proposal as a way to highlight what the cuts would mean, including the portion that will come from domestic programs supporting education, health and human services, and scientific research. President Obama is expected to sign the bill.

“Doc Fix” Uncertain

Congress continues to discuss how best to overhaul the system that Medicare uses to determine physician reimbursements, known as the sustainable growth rate (SGR).  The current rates are set to expire at the end of the year but little legislative progress has been made. Most lawmakers agree that they want to replace the current formula but there are still questions about the government’s role in determining doctors’ payments. These questions, along with disagreement on how to pay the nearly $300 billion cost of repealing the current formula, are obstacles to any comprehensive solution.

The current reimbursement formula was put in place to try to limit spending growth in Medicare. For ten years, the formula has called for cuts in physician payment rates, and Congress has enacted a series of payment patches to avoid those reductions. Physicians face a nearly 28 percent rate cut when the latest patch expires at the end of this year. UW physicians would be negatively affected if Congress allows the current SGR extension to expire.

Labor-HHS-Ed Bill Status

The House Appropriations Committee has not yet announced a full committee markup for its FY 2013 Labor-HHS-Education spending bill, and now many are raising doubts that it will ever do so. On Monday, Congressman Norm Dicks (D-WA), ranking Democrat on the House Appropriations Committee, expressed his belief that his GOP colleagues have “indefinitely postponed” further work on the Labor-HHS-Education bill. The current draft of the bill seeks to de-fund implementation of the 2010 health care overhaul (Affordable Care Act), and also contains policy riders and cuts to education programs. In the Senate, appropriators still say they will mark up two spending bills before the August recess. The committee may unveil its Defense and Legislative Branch measures next week, although expectations are dim for a markup of the Interior-Environment bill.

The Labor-HHS-Education bill is the last one remaining to be finished by the House Appropriations Committee, which already has approved its 11 other bills. The Senate Appropriations Committee has approved nine of their 12 bills.

Congress Talks CR, Appropriations, and Sequester

FY 2013 Continuing Resolution:  Several Republican lawmakers are advocating for an early vote on a stopgap spending bill for FY 2013 that would keep the government running into early next year, leaving contentious funding decisions for the next Congress. Most believe they are betting that they’ll have more power next year – possible control of the Senate and the White House – and will be in a better position to force deeper spending cuts. In a letter circulated by Senator Jim DeMint (R-SC), and signed by 20 members of the House and Senate, lawmakers said they would try before the August recess to clear a continuing resolution (CR) at a “fiscally responsible” level that would avert a new standoff over a potential government shutdown in the fall. Conservatives may support at CR at roughly the current annual spending level of $1.043 trillion if it extended into the next session of Congress, offering a temporary cease fire in the House GOP’s current efforts to cut $15 billion from discretionary spending through the FY 2013 appropriations process.  Regardless of this new effort, no decisions are likely before September. Few Democrats are likely to back a CR that extends beyond December. You can read the Republicans letter here.

L-HHS-ED Appropriations:  On Wednesday, the House L-HHS-ED Appropriations Subcommittee approved their FY 2013 draft spending bill mostly along party lines 8-6. The bill would provide a total of $150 billion in discretionary funding, which is $6.3 billion below FY 2012 levels and $8.8 billion less the President’s request. Much of the House panel’s debate centered on the bill’s health provisions and primarily on GOP efforts to repeal the Affordable Care Act, but Democrat’s efforts to restore that funding fell short. Congressman Norm Dicks (D-WA) also offered an amendment that would have removed GOP-supported language that would rescind funding for the Corporation for Public Broadcasting and National Public Radio.   

Sequester:  Also on Wednesday, House lawmakers approved legislation that would force the Administration to detail how automatic budget cuts due early next year would be implemented. The bill (HR 5872) would require the White House to produce a report within 30 days explaining how the $109 billion in cuts scheduled to take effect January 2, 2013 would affect both domestic and defense programs. The Senate passed similar legislation in June, but that plan calls for more detailed reports from the Defense Department, the Office of Management and Budget, and the White House on the cuts. It’s unclear how the issue will be resolved between the House and Senate bills.  The Senate could back the House bill, but it’s unclear if Democrats leaders, who pushed for the version that requires more detail about the impact on domestic cuts, will allow it to come up. Lawmakers would prefer to have a deal in place before the August recess, so they can have the information when they return in September to argue for averting the sequester.