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What it Means for Health Care
Alliance for Health ReformSeptember 12, 2011
Katherine HayesThe George Washington University School of Public Health and Health ServicesDepartment of Health Policy
Budget Control Act of 2011: OverviewDebt CeilingBalanced Budget Amendment VoteJoint Select Committee on Deficit ReductionEnforcement
Sequestration (of discretionary spending in a given FY)
Sequestration of up to $1.2 billion if no deficit reduction enacted and revision of discretionary spending caps
Education Provisions (not addressed today)
Debt Ceiling Increase: Three-steps $2.1 (or up to $2.4 trillion)$400 billion – Presidential certification (August
2, 2011)$500 billion – 50 calendar days after initial
certification (September 21, 2011)$1.2 t0 $1.5 trillion
$1.2 billion – $0 to 1.2 billion in deficit reduction enacted
$1.2-1.5 billion – Actual deficit reduction amount enacted
$1.5 billion – Constitutional amendment on balanced budget passes
Balanced Budget AmendmentCongress must vote on a balanced budget
amendment to the ConstitutionSeptember 30 – December 31, 2011If both Houses approve, debt ceiling can be
increased by $1.5 trillionExpedited procedures for 2nd chamber
consideration
Limits on Discretionary Spending10 year “adjustable” statutory limits
(appropriations caps) for FY 2012-2021FY 2012 and FY 2013 - Equally split between
Security (DoD, DHS, DVA, NNSA, intelligence, international affairs)
Non-security (everything else)FY 2014-2021 – no split between security and
non-securityEnforcement
Annual Enforcement of Discretionary Spending Caps15 days after end of a Congressional sessionIf appropriations within a category is exceed,
sequestration is triggered in “nonexempt” accounts.
President issues sequestration order within category breached (security v. non-security) in FY 2012-13
Congress can modify sequestration order (expedited procedure)
Joint Select Committee on Deficit ReductionDeficit reduction target of at least $1.5
trillion FY2012-2021Expedited procedure for consideration of
legislation (if any) reported by Super Committee
If no deficit reduction legislation enacted by January 15, 2011, (minimum of $1.2 trillion) automatic spending reductions go into effect on January 2, 2013 (unless there is intervening legislation).
Super Committee DeadlinesAugust 16, 2011 – Appointment of MembersSeptember 16, 2011 – Committee must begin meetingOctober 14, 2011 – House and Senate Committees
may make recommendationsNovember 23, 2011 – Committee must vote on
proposed deficit reduction legislation and report December 2, 2011 – If adopted, transmit to President,
VP and House and Senate leadersDecember 9, 2011 – Committees of jurisdiction reportDecember 23, 2011 – Final passage January 15, 2012 – Sequestration fallback if no law
enactedJanuary 31, 2012 – Committee dissolved
Joint Select Committee on Deficit Reduction – House MembersHouse
Speaker Boehner (R-OH) Jeb Hensarling (R-TX) – Committee co-chair Dave Camp (R-MI) Fred Upton (R-MI)
Minority Leader Pelosi Chris Van Hollen (D-MD) Jim Clyburn (D-SC) Xavier Becerra (D-CA)
Joint Select Committee on Deficit Reduction – Senate MembersSenate
Majority Leader Reid (D-NV) Patty Murray (D-WA) – Committee co-chair Max Baucus (D-MT) John Kerry (D-MA)
Minority Leader McConnell (R-KY) Pat Toomey (R-PA) John Kyl (R-AZ) Rob Portman (R-OH)
Deficit Reduction FallbackIf Super Committee bill is passed by January 15,
2012:Automatic spending reductions of amount full
$1.2 billion or any shortfallDiscretionary caps revised: equally split between
security and non-security (note)Proportional division between discretionary and
direct spendingCertain direct spending exempt or limited (Social
Security, Medicaid, and others, Medicare – 2%)Spending reductions beginning January 2, 2013