House Republican leaders are holding conversations with lawmakers as they decide whether to push the total amount of discretionary spending for fiscal year 2013 below the level set in last August’s debt ceiling law. Three different figures are being discussed as potential discretionary limits for the fiscal year 2013 House budget resolution, which is expected to be released later this month. Whatever figure is chosen would become a ceiling for the total of all appropriations measures debated on the House floor for the budget year which begins October 1. The three levels of spending being discussed include: $1.047 trillion — which is the discretionary spending cap for the coming year set by the debt limit law and under which discretionary spending would be allowed to rise by $4 billion from the current year’s level; $950 billion; and $931 billion. In the Senate, meanwhile, there is bipartisan agreement to stick with the $1.047 trillion cap from the debt limit law.
Senate Budget Chairman Kent Conrad (D-ND) expressed optimism this week that consensus could be reached on curbing Medicare spending by overhauling the program’s payment structure. Medicare’s current fee-for-service system has long been blamed for the program’s rapidly increasing growth rate in spending. The three expert witnesses at Wednesday’s Budget Committee hearing called for a structural overhaul of the payment system, saying it encourages patients and providers to prioritize quantity over quality of services.
Medicare’s actuary warned Tuesday that controlling cost growth is the primary challenge to the program’s financial stability, but that neither the premium support system sought by Republicans nor the cost-cutting measures pushed by the administration provide all the answers. Richard S. Foster, chief actuary for the Centers for Medicare and Medicaid Services, testified alongside Social Security Actuary Stephen C. Goss during a House Budget Committee hearing on strengthening the finances of the two programs. Both urged lawmakers to find solutions, but committee members were far from agreement. Chairman Paul Ryan (R-WI) and ranking Democrat Chris Van Hollen (D-MD) concurred at the morning hearing that they wanted to move quickly if they could reach bipartisan solutions.
A House panel on Wednesday backed legislation that would abolish an independent board charged with curbing Medicare spending growth, a Republican bill that has won some Democratic supporters. The Energy and Commerce Health Subcommittee voted 17-5 for the measure (H.R. 452), which would repeal the 15-person Independent Payment Advisory Board created by the 2010 health care overhaul. The board — which will comprise independent experts appointed by the president and confirmed by the Senate — is tasked with making cost-cutting recommendations if Medicare spending exceeds target growth rates. The bill will be brought before the full Energy and Commerce Committee for a vote, though the timing is unknown.
Next week, the Senate is planning to complete a $109 billion surface transportation bill (S. 1813). The House Appropriations Subcommittee on Financial Services and General Government will hold hearings on Monday, March 5, Tuesday, March 6, and Wednesday, March 7, titled: “Fiscal 2013 Appropriations: Financial Services.” The House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies will hold a hearing on Tuesday, March 6, titled: “Fiscal 2013 Appropriations: Labor, HHS, and Education.”