Budget Diagnosis, Part 1: The Looming Threat to Every Major Health Care Initiative

This is the first in Budget Diagnosis, a series on the coming major decisions in Congress that could affect your health care. This series explains, simply, what advocates need to know, features special guests writing about different groups and populations that will be especially vulnerable, and provides you with updates from D.C.

The Presidential election is over—and voters chose the candidate who wants to move forward on health care. They rejected calls to repeal the Affordable Care Act, cut Medicaid by one-third, and put seniors at the mercy of private insurance companies. But you don’t have to look far to see the next big debate on Medicaid, Medicare, and the Affordable Care Act. The next big event starts right now.

At the end of this year, a series of automatic spending cuts and tax increases will go into effect, potentially touching virtually every American household, unless Congress acts. This is what is being called the “fiscal cliff.” Democrats and Republicans have different philosophies about how to handle the fiscal cliff. Conservatives think that simply cutting Medicaid and Medicare—programs that serve our children, elderly, people with disabilities, low-income families, and families struggling to care for a loved one who needs long-term care—and shifting more of the costs to consumers will solve our budget problems. But it won’t. The underlying inflation in health care costs, the increasing numbers of people living at the financial edge, and the growing aging population all contribute to the cost of these programs. Shifting costs to families, seniors, and people with disabilities too often means some will go without the care they need and that can cost more in the long run. Bad federal budget choices will leave families to face their own devastating budget choices about how pay for a child’s visit to the doctor or an elder parent’s needs.

So, why is Congress spending so much time on the fiscal cliff and other handwringing debates about debt and deficit while we have other important issues—like creating more jobs—to worry about? The fact is the President and Congressional leaders are convinced that we should begin to take steps to bring down our long-term deficit, while not harming our still fragile economic recovery. The key question: Will Congress address the deficit in a sustainable and balanced way that doesn’t hurt struggling families? If you care about health care for our most vulnerable folks, then it’s time for you to put your battle armor back on and get ready to prevent what could be dangerous cuts and structural changes.

We don’t yet know what Republican proposals will look like, but the past few years have given us some insight:

• The past two Republican budgets passed by the House of Representatives balanced the debt largely on the backs of the most vulnerable, slashing Medicaid through a block grant, turning Medicare into a voucher, and repealing the Affordable Care Act.
• We will see similar attempts again, as conservatives have made it clear that their goal is to completely dismantle the health care safety net. Past negotiations have shown little willingness from them to budge on this point.

In 2011, your voice ensured that the Affordable Care Act, Medicaid, and Medicare benefits were protected in budget negotiations. It’s time to act again to ensure Congress doesn’t increase inequality and poverty. Let’s make sure that Congress addresses our budget in a balanced way that actually helps our country’s literal and fiscal health.