Category Archives: Medicaid

Republican Senators Threaten to Oppose Debt Ceiling Increase

Twenty-two Republican senators “are threatening to vote against raising the debt ceiling later this year unless the president concedes to cuts in Social Security, Medicare and Medicaid in the current budget negotiations,” POLITICO reports.

“Strong leadership is needed now to advance possible solutions to ensure that our entitlement programs can serve both current and future generations. Without action to begin addressing the deficit, it will be difficult, if not impossible, for us to support a further increase in the debt ceiling,” wrote Sen. Dan Coats (R-Ind.) in the letter, obtained by POLITICO.


But the group of almost two dozen GOP senators are withholding their vote to raise the debt ceiling until, as Coats writes, President Barack Obama exhibits the same leadership that former President Ronald Reagan and then House Speaker Tip O’Neill in 1983 when they tackled Social Security reform.

“A similar show of leadership from you and from congressional leaders of both parties is necessary to address the long-term challenges facing our country,” wrote the GOP senators.

Who signed onto the letter:

In addition to Coats, the GOP senators to sign onto the letter are: Sens. Lindsey Graham (S.C.), John Cornyn (Texas), John Ensign (Nev.), Jim Risch (Idaho), Mike Crapo (Idaho), Mike Lee (Utah), Lamar Alexander (Tenn.), Rand Paul (Ky.), Richard Burr (N.C.), Kelly Ayotte (N.H.), Ron Johnson (Wisc.), Tom Coburn (Okla.), Marco Rubio (Fla.), Kay Bailey Hutchison (Texas), Mike Enzi (Wyo.), Bob Corker (Tenn.), Richard Lugar (Ind.), Saxby Chambliss (Ga.), Pat Roberts (Kan.), Roger Wicker (Miss.) and Mike Johanns (Neb.).

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Filed under Debt Ceiling, Letters, Medicaid, Medicare, Social Security, White House

Berwick Nomination Unlikely to Move Forward

Senate Democrats “have given up on confirming Don Berwick as CMS (Centers for Medicare & Medicaid Services) administrator in the wake of a letter from 42 Republican senators opposing the nomination, sources tell POLITICO.”

Citing the GOP letter, a person familiar with the situation said Senate Democrats and the White House "can do the arithmetic" and now see that there’s no way for Berwick to get the 60 votes needed to clear the Senate.

At a meeting with health care lobbyists Friday, Democratic Senate Finance Committee staffers indicated that the nomination is dead, that there will be no confirmation hearing, and that they’ll soon be discussing "next steps" for CMS, sources said.

Berwick “received a recess appointment in July and was renominated in January.” If he is “not confirmed by the Senate, Berwick will have to leave by the end of 2011.”

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Filed under Medicaid, Medicare, Nominations

Senate Republicans Urge President to Withdraw Berwick Nomination

Senators Orrin Hatch (R-UT) and Mike Enzi (R-WY) have written a letter to President Obama urging him “to withdraw the nomination of Dr. Donald Berwick to head the Center for Medicare and Medicaid Services (CMS),” according to a press release.

Hatch is Ranking Member on the Senate Finance Committee while Enzi is Ranking Member on the Senate Health, Education, Labor and Pensions Committee.

They were joined by the following Republican members:

In addition to Hatch and Enzi, the following Senators also signed the letter:  Lamar Alexander (R-Tenn.), Kelly Ayotte (R-N.H.), John Barrasso (R-Wyo.), Roy Blunt (R-Mo.), John Boozman (R-Ark.), Richard Burr (R-N.C.), Saxby Chambliss (R-Ga.), Dan Coats (R-Ind.), Tom Coburn (R-Okla.), Thad Cochran (R-Miss.), Bob Corker (R-Tenn.), John Cornyn (R-Texas), Mike Crapo (R-Idaho), Jim DeMint (R-S.C.), John Ensign (R-Nev.), Lindsey Graham (R-S.C.), Chuck Grassley (R-Iowa), John Hoeven (R-N.D.), Kay Bailey Hutchison (R-Texas), Jim Inhofe (R-Okla.), Johnny Isakson (R-Ga), Mike Johanns (R-Neb.), Ron Johnson (R-Wis.), Mark Kirk (R-Ill.), Jon Kyl (R-Ariz.), Mike Lee (R-Utah), Dick Lugar (R-Ind.), John McCain (R-Ariz.), Mitch McConnell (R-Ky.), Jim Moran (R-Kan.), Ron Paul (R-Ky), John Risch (R-Idaho), Pat Roberts (R-Kan.), Marco Rubio (R-Fla.), Jeff Sessions (R-Ala.), Richard Shelby (R-Ala.), John Thune (R-S.D.), Pat Toomey (R-Pa.), David Vitter (R-La.), and Roger Wicker (R-Miss.).

All told, it was signed by 42 Senators. Read the full letter here.

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Filed under Medicaid, Medicare, Nominations, White House

Democrats Want Social Security Separated from Deficit Reduction Plan

Senate Democrats “want to put the Social Security trust fund in a lockbox and insulate it from a broader budget-cutting package designed to reduce the national deficit,” The Hill reports.

Senate Budget Committee Chairman Kent Conrad (D-N.D.), who is at the center of bipartisan talks, said he wants to prolong the solvency of Social Security to 75 years. Under its current setup, the program is projected to pay 100 percent of benefits for the next 26 years.

But Conrad does not want Social Security to be part of a broader proposal to reduce the $1.6 trillion federal deficit.

“It might be useful to have Social Security treated on a separate track because it is not part of the deficit reduction package,” Conrad told The Hill before the Presidents Day recess. “I think it should be separated.”

“There are many who recognize we have a long-term challenge with Social Security but that’s very separate from the deficit reduction,” Conrad said. “When those two get put together, it creates huge problems to getting the deficit reduction done because it confuses the issue.”

Conrad says lawmakers “should look instead to reducing projected costs in other entitlement programs, such as Medicare and Medicaid.”

This is an area of “potential disagreement with Tom Coburn (R-Okla.), who is meeting regularly with Conrad and Sens. Dick Durbin (D-Ill.) and Mike Crapo (R-Idaho) to put together a deficit reduction plan.”

Coburn warns that if Social Security reform is not part of the package, Congress won’t address it for years.

“Nothing will ever happen if we do it that way,” Coburn said of the prospect of separating Social Security from a deficit reduction package.

Senator Bernie Sanders (I-VT), founder of the Senate Social Security Caucus, says he thinks “there is growing sentiment within the Democratic caucus to make sure that Social Security is not dealt with within the context of deficit reduction.”

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Filed under Budget, Medicaid, Medicare, Social Security

Bipartisan Senate Group Working on Deficit Reduction Plan

A bipartisan group of Senators “is considering legislation that would trigger new taxes and budget cuts if Congress fails to meet a set of mandatory spending targets and other fiscal goals aimed at reducing federal deficits,” the Wall Street Journal reports.

The plan would break the task of deficit reduction into four pieces: a tax code overhaul; discretionary spending cuts; changes to Medicare, Medicaid and other entitlements; and changes to Social Security, aides said. The Social Security system is on firmer financial footing than other major entitlement programs and raises political sensitivities that lawmakers want to deal with separately.

The proposal builds on the work of President Barack Obama’s deficit commission, according to aides working on it.

"We’re getting close," said Senate Majority Whip Richard Durbin (D., Ill.), one of six senators working on the plan. "We understand that if we’re going to do something that’s important, it has to be timely." He said the group hopes to reach agreement "in a matter of weeks, or months."

In addition to Mr. Durbin, the second-ranking Senate Democrat, the group include[s] Budget Committee Chairman Kent Conrad (D., N.D.), and one of the Senate’s most conservative fiscal hawks, Tom Coburn (R., Okla.). Messrs. Coburn and Durbin are personally close to President Obama.


The Senate group’s working plan calls for placing separate caps on security and nonsecurity spending, and missing a budget target in one area would not trigger mandatory cuts in the other. The spending targets would follow proposals laid out by the deficit commission, which recommended cutting discretionary spending by $1.7 trillion through 2020. Lawmakers on the spending committees would draft legislation to meet the targets. But if they were not met, automatic, across-the-board cuts would go into effect.


The tax-writing committees would be given two years to overhaul both the individual and corporate tax codes, with general instructions to close tax breaks and minimize or eliminate tax deductions while lowering tax rates. The committees would be given a target for additional revenues to be raised by the new code. The deficit commission’s version of tax reform would net $180 billion in additional revenues over 10 years.

If Congress failed to enact the tax code overhaul, the legislation would mandate an across-the-board tightening of tax deductions to meet the higher target.


Changes to Medicare, Medicaid and other entitlements such as agriculture subsidies and military and civil service retirement plans would also have to meet fixed targets. Social Security, however, would not incur automatic penalties if lawmakers failed to make changes.

Social Security:

If the Social Security effort failed, the deficit commission’s plan—a mix of raising the level of wages subject to Social Security taxes, slowly increasing the retirement age and other smaller changes—would go to Congress for an up-or-down vote. But there appears to be little appetite for automatic cuts if neither option were to pass.

Other Senators “involved in the negotiations include Virginia Sen. Mark Warner, a Democrat, and two Republican senators, Mike Crapo of Idaho and Saxby Chambliss of Georgia.”

The framework of “targets and penalties is expected to be circulated to a broad group of senators by early next month.”

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Filed under Budget, Medicaid, Medicare, Social Security, Taxes