The National Association for the Advancement of Orthotics & Prosthetics President Paul Prusakowski, CPO, FAAOP; Executive Director, George Breece; and General Counsel Peter Thomas issued the following update today regarding the proposed fiscal year 2012 federal budget and its impact on Americans who have significant healthcare conditions, including those in need of orthotic and prosthetic care:
While the potential for a government shutdown looms due to the inability of Congress and the President to reach agreement on spending levels for the federal agencies for the remainder of Fiscal Year (FY) 2011, House Budget Committee Chairman Paul Ryan (R-WI) yesterday released details of his proposed fiscal year 2012 federal budget.
The House proposal for FY 2012 makes it clear that the key set of issues that will define the political agenda going into the 2012 elections will center around fiscal policy. The current stalemate between the House and Senate over spending mere billions of dollars for the next six months pales in comparison to the budget blueprint released today, which calls for multiple trillions of dollars in spending reductions over the next ten years.
Regardless of where one stands on the political spectrum, there is no question that the policies proposed in the FY 2012 House budget are breathtaking in scope and will impact all Americans, but in particular, people with significant healthcare conditions and disabilities, including people in need of orthotic and prosthetic care. To be fair, it should be noted that these proposals are not entirely a surprise. Chairman Ryan has been signaling for months his intention to follow many of the recommendations made by two bipartisan fiscal commissions that produced similar recommendations late last year.
Highlights of the proposed House budget that impact healthcare include for following:
- It cuts massive amounts of funding from Medicare and Medicaid over the next decade.
- It converts the Medicare program (which covers 42 million seniors and 6 million people with disabilities below 65) from an entitlement into a “premium support” program and relies on the private market to cover beneficiaries. The federal contributions to premiums are not designed to keep pace with medical inflation, however, so beneficiaries will have to pay more for Medicare coverage out of their own pocket with each consecutive year or find plans with more modest benefit packages.
- It converts the Medicaid program from an entitlement into a “block grant” program to the states that will significantly increase the financial burden on states (and on Medicaid beneficiaries) to pay for healthcare. This will undoubtedly have a major impact on access to benefits such as rehabilitation, orthotics, prosthetics, and durable medical equipment, to name only a few of the categories of benefits to be affected.
- It repeals and defunds the Affordable Care Act and would reverse any increases in coverage under Medicaid and in the private insurance market set to take place in 2014. This would mean that pre-existing condition exclusions and other insurance practices that segregate the private market into good risks and bad risks would continue to be in effect.
- It rolls back funding for healthcare and other discretionary spending programs to FY 2006 levels and then freezes those levels for five years. These dramatic spending reductions will have a major impact on the ability of agencies such as the National Institutes of Health (NIH), the National Institute on Disability and Rehabilitation Research (NIDRR), the National Science Foundation, and the Health Resources and Services Administration (HRSA) to continue programs that impact O&P and many other areas of healthcare.
Some observers of the spending negotiations this week between Congress and the President anticipate that the Ryan budget proposal may enable Congress to avoid a shutdown simply by putting into perspective the enormity of the next budget debate and taking emphasis off the current spending stalemate. However, the spending agreement deadline is fast approaching, and if an agreement is not reached by Friday, April 8, the shutdown will take place-at least temporarily.
President Obama held a meeting with House and Senate leaders yesterday in an attempt to reach a last-minute compromise, but a deal was not struck. In addition, this past Monday night, House Appropriations Chairman Hal Rogers (R-KY) introduced a seventh continuing resolution (CR) that would extend the spending deadline by one week, to give the parties one more chance to reach agreement, but it is unclear whether this new CR can pass.
Specifically, the House Budget proposal for FY 2012 would cut $6.2 trillion in spending over the next decade compared to President Obama’s budget for 2012. The plan also projects that it would eventually bring government spending to below 20 percent of the gross domestic product (GDP). The budget is expected to be “marked up” in committee today and could be ready for a vote on the House floor as early as Friday-the same day the current CR for FY 2011 expires.
At the same time, a bipartisan group of senators, including Budget Chairman Kent Conrad (D-ND) and Senator Tom Coburn (R-OK), are holding negotiations on legislation that could reflect President Obama’s deficit reduction commission’s report, which was released last year. Many of those recommendations were similar to the Ryan budget proposal and were quite controversial at the time of their release.
In conclusion, the stalemate over spending and the proposals to cut trillions of dollars out of the federal budget over the next decade are issues that are not easy to resolve, especially in a charged political climate.
NAAOP will continue to keep its members and friends informed of developments as they occur. For more information, visit www.naaop.org or e-mail [email protected]. Access NAAOP’s Congressional Legislative Action Center at www.naaop.org to communicate with your congressman or senator.
