Congressional Republicans may inject controversial healthcare changes into the dealmaking as the debt-ceiling deadline looms on Nov. 3 and the continuing budget resolution is set to expire on Dec. 11.
Senate Majority Leader Mitch McConnell (R-Ky.) reportedly wants to limit Medicare benefits to more-affluent seniors and raise the program's eligibility age in return for increasing the borrowing limit and funding the government. The White House has said it would not accept those proposals in the current negotiations.
It's unclear whether GOP leaders will press such demands to the point of throwing the government into default or shutting it down, given the upcoming 2016 elections. But a delay in reaching a budget deal could hurt healthcare organizations.
Under a government shutdown, federal healthcare agencies such as the National Institutes of Health would stop operating until their appropriations are approved, said Joseph Antos, a health policy expert at the conservative American Enterprise Institute. Rural and safety net hospitals also would be hard hit.
Still, Edwin Park, vice president for health policy at the liberal Center on Budget and Policy Priorities, said negotiations around removing or adjusting budget sequester cuts could involve Medicare cuts. He also noted that 30% of beneficiaries will face a sharp increase in Part B premiums if no congressional remedy is approved.
Despite the Dec. 11 deadline, Antos said he doesn't expect congressional talks to get serious until after the Thanksgiving break, but believes an agreement will be reached before Christmas. “This is the pattern we've seen for a few years now,” he said. And he's confident the debt-ceiling hike will be approved. “There's very little question in my mind,” he said.
