Health On The Hill: Debt Limit Talks Intensify As Deadline Nears

Jackie Judd and KHN’s Mary Agnes Carey discuss the rising tension on Capitol Hill over increasing the debt limit, which seemed still largely mired along party lines Thursday. Republicans continue to want spending reductions to give their blessing to raising the debt ceiling while Democrats want to raise taxes in return, and many special interest groups are also weighing in on how changes could affect them.

Listen to the audio or read the transcript:

JACKIE JUDD: Good Day, This is Health on the Hill. I’m Jackie Judd.

And on it goes. The negotiations between President Obama and Republican leaders over raising the national debt limit continue at the White House. Tempers are rising; the gulf between the two sides seems to be widening. Mary Agnes Carey of Kaiser Health News is on Capitol Hill covering all the developments, and she joins us now.  Mary Agnes, welcome.

MARY AGNES CAREY: Thank you.

JACKIE JUDD: I don’t know how many news conferences you may have covered today, but when all is said and done, what is the big picture?

Has there been any movement on either side?

MARY AGNES CAREY: Not really, Jackie.  Everyone’s kind of sticking to their script.  Republicans are saying: We need to have spending reductions before we can raise the debt ceiling.  They want to see more spending cuts; they want to see cuts in entitlement programs like Medicare and Medicaid.  The Democrats, of course, maintain their line that they are fierce defenders of beneficiaries of Medicare and Medicaid.  They might be willing to make some changes that they don’t think would be negative to beneficiaries – they might be willing to do that if they saw more tax increases out of the Republicans, which of course is a place they don’t want to go.  So everyone seems to be in the same place they’ve been for days.  

JACKIE JUDD: And when you talk to politicians and their staff behind the scenes, are you hearing anything different from the public pronouncements?

MARY AGNES CAREY: People seem to want to be measured in their remarks.  They want to be careful in their remarks.  I’ve been talking freshman Republicans, I’ve been talking to seasoned veterans in both parties, and people seem – they want to be responsible, they understand what’s at risk here if the government defaults, and they know  that there will be a lot of serious  economic consequences.  But they seem to feel that this is also to be expected, because you’re talking about changes – in the entitlement area, for example – you’re talking about potential changes in spending patterns that have been the norm for a long time.  So they think it’s part of the mix, it’s part of the game.  They want to be reasonable.  I don’t get a sense of panic too much that this won’t be resolved at some point, but people seem to be keeping their eye on the ball and on the calendar, of course, because we’re up against this August 2 deadline.

JACKIE JUDD: Is there an anxiety though, particularly among liberal Democrats, about what the White House may be willing to do in terms of altering the way some of the entitlement programs, the health care programs do operate at the moment?

MARY AGNES CAREY:  I think there was some surprise about the reports that the president suggested an increase in the Medicare eligibility age.  I think that took a lot of Democrats by surprise.  And, of course, politically the idea of protecting Medicare has been beneficial for Democrats, especially in the House, up against the Paul Ryan proposal which would have changed Medicare to a fixed contribution by the government, would change Medicaid to a block-grant program.  House Democrats have been out there campaigning fiercely that we’re the protectors of Medicare.  So there has been some concern that some of the cuts that are on the table, some of the suggestions about changes in entitlements aren’t maybe the place really want to be heading into a campaign where they think they can win back the House.

JACKIE JUDD:  This isn’t only about lawmakers, about the president, it’s also about special interest groups.  It’s about industries that are impacted by these discussions, particularly as they apply to the health care programs.  Are you seeing many more lobbyists on the Hill these days than is normal?  Are you seeing many more radio and television campaigns being launched around these negotiations?

MARY AGNES CAREY:  You’re seeing both, especially in the messaging area.  For example, the medical schools are very upset about this potential cut in graduate medical education.  They’re trying to appeal especially to Democrats to say, look, you backed a health law that’s going possibly cover up to 32 million people, that’s the goal.  How can you do that with fewer trained doctors?  They’ve really honed their message on that.

AARP has come out swinging with a campaign geared to the entire Capitol Hill — both sides of Congress — saying don’t change Medicare, don’t cut Medicare, don’t cut Social Security.  The tag line of this ad is very interesting:  You may think that we’re wearing a target, but you forget that there’s 50 million of us.  So they really want lawmakers and the president to understand the power of the seniors’ lobbying group.

The hospital groups have been on this for weeks, and they’ve stepped up their campaigns.  They’re spending $1 million a week through August for radio, TV, Internet, print ads, basically saying that if you cut Medicare and Medicaid, you’re going to overload the ERs, you’re going to shut down trauma units.  Patients are going to have problems getting access to care.  So they’re really trying to broaden their message to the public.  No one really knows how this is going to go on Medicare and Medicaid cuts, so you’ve got all these different groups trying to say to Congress, this is our value.  This is why you shouldn’t cut us.

JACKIE JUDD:  Thank you very much.   I know we’ll be talking about this again, Mary Agnes Carey of Kaiser Health News.

MARY AGNES CAREY:  Thank you.