On the same day that the first members of the powerful new congressional deficit-reduction committee were announced, one group of healthcare providers sought to influence the panel's composition.
Rural representation on debt panel has its perils
The National Rural Health Association wrote leaders of both chambers of Congress on Tuesday to urge that they use “proportional representation” when picking the 12 members of the deficit reduction panel authorized by the Budget Control Act of 2011. The panel is charged with finding at least $1.5 trillion in 10-year deficit savings by Nov. 23.
“A true understanding of the differences in the delivery systems for rural America is vital to understanding the current funding levels and payment mechanisms that Congress has put in place,” the group wrote. “It is, therefore, vital to these facilities, patients, and the rural healthcare safety net that members of this new committee come from rural states and districts.”
Proportional representation, according to the group's letter, would match the ratio of committee members from rural states and districts to the ratio of rural Medicare beneficiaries. The organization used as the basis for comparison the CMS Statistical Supplement for 2004, which reported rural beneficiaries were 26.8% of the overall Medicare population.
So far, so good.
Among the nine members appointed to the committee, as of Wednesday morning, one—Sen. Max Baucus (D-Mont.)—is from an indisputably rural state and three—Reps. Jeb Hensarling (R-Texas), Dave Camp (R-Mich.) and Fred Upton (R-Mich.)—are from districts with “many rural communities,” according to one of their websites. So 44.4% rural representation on the committee appears well clear of the NRHA's standard.
Of course, the provider organization eventually may regret getting what it wants, if the 2009 to 2010 federal healthcare battle was any indicator. The panel's recommendations could be slammed by critics—or even rejected by lawmakers—because the membership over-represents the rural population. Some 16% of the country's population lives in rural areas, according to 2010 U.S. Census Bureau figures.
In the summer of 2009, liberal groups and commentators savaged the members of the Senate's so-called “Gang of Six” when they were negotiating the version of healthcare reform that eventually became law. Those senators were specifically attacked because, it was said, they represented rural states that composed only 2.6% of the U.S. population and therefore were unqualified to decide the shape of legislation that would affect the entire nation.
There's little doubt that any agreement the so-called “super committee” reaches will similarly affect the entire nation.
You can follow Rich Daly on Twitter @MHRdaly.
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