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Health On The Hill: “Super Committee”: Recipe For Gridlock Or Potential For Consensus?

KHN’s Mary Agnes Carey and Politico Pro’s David Nather talk to Jackie Judd about the now complete “super committee” and what it may mean for Medicare and Medicaid.

Listen to the interview here.

Here’s a transcript of the interview:

JACKIE JUDD: Good day, this is Health on the Hill – I’m Jackie Judd.  The so-called “super committee” – charged with finding ways to reduce the federal deficit over the next decade – is now complete. House minority leader Nancy Pelosi filled in the last three chairs today when she appointed Congressmen VanHollen, Clyburn and Beccera. Here to discuss the make-up of the “super committee” and what that may mean for health care programs: KHN senior correspondent Mary Agnes Carey and from Politico Pro David Nather.  Welcome to you both. 

David, generally, what was the message that each party leader may have been telegraphing by making the appointments that they did?

DAVID NATHER:  Well, the main message is party loyalty.  You have the two co-chairs of the “super committee:” you have Jeb Hensarling of Texas, the fourth ranking House Republican leader, and on the Democratic side, you have co-chair Patty Murray, who also just happens to be the chair of the Democratic Senatorial Campaign Committee – the whole purpose of that committee is to get Democrats elected to the Senate.  They didn’t reach out to budget experts to head the “super committee.”  They didn’t reach out to moderate compromisers. They reached out to party leadership.  They do have – within the ranks of the “super committee – they do have others that could fit the description of more moderate compromisers, such as Max Baucus of Montana, he’s the Democratic Chairman of the Senate Finance Committee.  On the Republican side, you have Rob Portman of Ohio, who’s maybe a little bit more toward the moderate end of the GOP.  But for the most part, the panel is dominated by people with strong ideological leanings.

JACKIE JUDD:  Mary Agnes, from your research, where do you see any potential for consensus?  Or what ideas do you see possibly emerging when it does come to Medicare and Medicaid?

MARY AGNES CAREY:  I do wonder if the committee may try to take a long-range approach to Medicare.  For example, we’ve had several commissions over the last few years who have suggested things like a gradual increase in the eligibility age.  President Obama himself advanced that recently in the debt deal discussions.   Could you look at separate things – for example, the Part A and Part B deductible – and combine them?  That would benefit some beneficiaries financially; that could hurt others.  Would you look at the first-dollar Medigap coverage in Medicare?  Some Democrats may oppose  some changes to that, but it’s looked at as a disincentive to — first-dollar coverage could save money.  We’re talking about things that would take place out in the future, over time.  Perhaps not as radical as some view Paul Ryan’s plan on Medicare – in the sense of a limited amount of federal money for a beneficiary to make a choice — but there could be some middle ground there.  While Democrats have been fiercely defending Medicare and not wanting changes, I wonder if there could be some middle ground there.

JACKIE JUDD:  And a question for you both.  Even though there is much potential for disagreement given the political make-up that you, David, that you were describing earlier.  Does the environment we’re now existing in or living in — the stock market gyrations, the uncertainty about the economy, the unemployment picture — does this panel feel some pressure that perhaps other commissions and panels before them haven’t?

MARY AGNES CAREY:  Well, they’re definitely going to feel pressure, but you could also say that about the debt-ceiling talks that were led by Vice President Joe Biden and then the broader leadership talks that President Obama had.  They were facing pressure, too.  They had a deadline that they were up against to raise the debt ceiling, and yet the political stakes were so high — and working against compromise on entitlements and taxes — that they just couldn’t get there. 

Yes, this super committee has the trigger now that goes into effect if they can’t get a deal that cuts health care payments and defense spending.  There’s some pressure, but none of this takes away the fact that the biggest pressure of all is election year next year.  It’s really going to take a lot and maybe even more financial gyrations to really put enough pressure on them that they would be willing to give away big tradeoffs.

JACKIE JUDD:  Mary Agnes, the notion that, if this commitee fails, there is the automatic 2 percent trigger to follow.  Medicaid is off limits, if that should happen, but Medicare would be in play.  Do you think that there are people on Capitol Hill who would much prefer to see this go that route, the 2 percent cut, rather than having the committee make the decisions?

MARY AGNES CAREY:  There certainly could be if they feel the whatever the committee comes up with would be unfavorable to them, or they don’t want to take another vote on this with the debt ceiling — they’ve already had a vote on it.  So we’ll have to see how it plays out.  But I think David made some really great points about the partisanship on this panel and who has been appointed, which will make it extremely difficult to get consensus. 

But to your point about the market:  That’s really an area to watch.  If we continue to see this turmoil in the stock market, if you have another ratings agency downgrade the U.S. credit rating, what kind of pressure does that put on this committee to come up with a deal?  A lot of lawmakers and a lot of constituents who would be hurt by these across-the-board cuts, they’ll certainly put pressure on this committee to come up with a different solution.

JACKIE JUDD:  And a final question to David, and that is:  The timeline.  We now have the twelve.  There is a deadline in late November for them to report, but what happens in between?

DAVID NATHER:  In between there’s going to be about two months, basically, where this super committee can meet.  And right about in the middle, in mid-October, the regular committees that have jurisdiction over Medicare and Medicaid programs can, if they want, they can give suggestions to the super committee on where they think the savings should come.  But the super committee isn’t bound by any of them, of course.  Then it’s supposed to report its recommendations right before Thanksgiving.  Congress is supposed to vote on them without amendments right before Christmas.  So they will be up against another deadline that lawmakers always hold dear, which is their holidays.  But the real question is what are the markets going to be doing in the mean time.

JACKIE JUDD:  Okay, we will wait and see.  Thank you so much, David Nather of Politico Pro, and Mary Agnes Carey of Kaiser Health News.  I’m Jackie Judd.

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