Inaction Dominates Fall Congressional Deliberations
After a long summer recess, Congress returned to work for several days in September, but worked only briefly and has now recessed until after the Nov. 6 elections. The just-completed September agenda was very short, the main item of business being enactment of a stopgap federal spending bill necessary to fund government operations after Oct. 1. The stopgap funding bill is now law and roughly maintains current-year funding levels for federal programs, including those at the Substance Abuse and Mental Health Services Administration (SAMHSA), until March 27.
Congress did not address the Medicare physician-fee extension, which will now be one of two key items of business in a December lame-duck session (the period after the election and before the new members of Congress take office in January). Due to the short time frame and a stalemated political atmosphere, Congress has decided December’s Medicare physician bill will not include any additional measures, such as AMHCA’s Medicare provider status provision.
The other important item of business pending during December is the highly contentious legislation to relax mandatory spending cuts and avoid tax hikes that were previously enacted into federal law. Leaders of both parties hope the outcome of the congressional elections will make it easier to finish up these key items by the end of December.
Party leaders on both sides of the aisle are meeting with key White House officials to begin negotiations to avoid the massive tax hikes scheduled for next year. If talks are unsuccessful, existing law requires a sequestration process that will cut dramatically into current federal spending.
Budget sequestration refers to automatic, across-the-board cuts that are scheduled to go into effect Jan. 1 under the terms of the 2011 Budget Control Act. Under the sequestration process, SAMHSA and many domestic programs will receive an 8.2 percent cut, if it is enacted. Such cuts would be triggered by the failure of Congress to reduce deficit spending by a preset amount.
Early last year, AMHCA and its Medicare coalition partners, which included marriage and family therapists, succeeded in getting a bipartisan Senate bill introduced providing Medicare provider status for clinical mental health counselors and marriage and family therapists (S. 604). The coalition has since been engaged in an aggressive search for a House sponsor of a companion bill.
To date we have found no GOP (Republican) Representative willing to take the lead for such a measure. Winning a sponsor from the majority party is a critical step to moving almost any legislation in the House. Therefore our coalition has met with every House Republican on the committees of jurisdiction, along with virtually every GOP freshman.
While there is interest and tepid support from many, no GOP Representative has offered to assume this important House role. Nevertheless, our coalition has continued to seek a champion to build congressional awareness of the issue for any future Medicare bill that gets to the floor. With time running down on this Congress, it is very unlikely there will be any consideration given to Medicare coverage changes this year.
AMHCA believes the GOP resistance is largely due to the partisan standoff over Medicare and entitlement spending, making any movement on Medicare modernization impossible before next year. AMHCA encourages its members to continue to raise the issue with Senators and Representatives during the remainder of this year, but next year seems like a better opportunity for favorable consideration.
AMHCA plans a new and enlarged campaign for passage next year when Congress hopefully will be more willing to consider bipartisan Medicare reforms.
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