Details on the substance of the debt ceiling negotiations talks have been sparse amidst the drama of Rep. Eric Cantor's theatrics and Obama's frustration. But what substance we have seen suggests that President Obama
remains committed to deep cuts and some sort of grand bargain.
Working off of talks that had been spearheaded by Vice President Joseph Biden, the president said he would be comfortable signing off on northward of $1.5 trillion in discretionary spending and mandatory spending cuts. With additional negotiations, he added, he could move that figure up to $1.7 trillion, and with a willingness to consider revenue increases and tax loophole closures, lawmakers could get to over $2 trillion. His preference, he said, was to continue to push for the biggest package possible, so long as it was balanced.
That package likely includes the Medicaid cuts offered in the Biden negotiations, replacing the current state reimbursement formula with a "blended-rate" set signficantly below current state support. That would result in a cost shift to states that would mean keep cuts by the states. That appears to be the same proposal Cantor offered a few days ago, when Cantor and House Speaker John Boehner were pretending that they would be willing to go back to the Biden negotiation benchmarks.
That's got a number of organizations worried and lobbying hard to protect the program targeting a number of officials, including congressional Democrats and the White House.
WASHINGTON -- The top union representing state and local workers is putting pressure on moderate Senate Democrats to reject any debt ceiling proposals that would end up cutting funding to Medicaid.
The American Federation of State, County and Municipal Employees (AFSCME), one of the largest unions in the country, unveiled new plans on Wednesday to hold events in North Carolina to pressure that state's two senators -- Democrat Kay Hagan and Republican Richard Burr -- to rally behind the embattled low-income health care program.
That the union is rallying behind Medicaid reflects the extent to which labor leaders are worried about how even moderate cuts would affect their rank and file members. A recent study by the health care reform advocacy group Families USA showed that even a five percent cut in Medicare funding could result in the loss of well over 100,000 jobs (8,890 in North Carolina alone), not to mention the toll on state budgets.
Actual constituents have joined the effort to protect Medicaid, as Americans with disabilities and their families met with officials on Tuesday to stress the importance of Medicaid in closing gaps in the safety net. Their message:
Tackling our nation’s budget woes cannot be combined with an attack on people with disabilities, their families, and caregivers. Medicaid is a fundamental lynchpin for people with disabilities to live and work independently in communities across our nation. To drastically reduce this vital support is short-sighted and wrong. We welcome the chance to be a part of the solution.
They highlighted a fact that is reinforced today by a new report from Georgetown's Health Policy Institute:
[A]Lmost eight in 10 children with autism, cancer and other special healthcare needs who are enrolled in Medicaid or the Children's Health Insurance Program—about 2.9 million children—rely on those programs as their primary source of coverage. For many others, government programs fill the gaps for services not covered by private insurance or help with cost-sharing.
"Children have the most to lose in the budget debate if Medicaid takes the brunt of the budget cuts because they make up a disproportionate share of Medicaid beneficiaries," the paper concludes. "Children and youth with special health care have more at stake in the deficit debate than any others."
Medicaid is necessary, efficient, and should be on the chopping block than no more than Social Security or Medicare. Enacting these cuts now would completely undercut everything President Obama attempted to do with the Affordable Care Act, throwing more people in the ranks of the uninsured and, as a consequence, driving up health care costs for the country. It's a bad, bad idea.