Immediate threat removed to current entitlement payments
There will be no interruption of critical safety net benefits such as SSI and SSDI disability benefits. Failure to deal with the debt limit would have placed these cash benefit programs at risk. This action also ensures that quarterly matching payments to state Medicaid agencies and payments to housing agencies for rental assistance programs (like Section 8) will not be interrupted. Many people living with mental illness depend on SSI, SSDI, Section 8 for basic support.
Medicaid Protected from Future Cuts
The agreement includes a "firewall" protection in the future deficit reduction process that will ensure that Medicaid cannot be targeted for reductions. The $1.5 trillion in savings will come from changes in entitlement programs and reforms to tax code (loopholes, exemptions from those with higher income, etc.) but again, they are not allowed to recommend cuts or savings from Medicaid or Social Security. Savings from Medicare must come from payments to health plans and hospitals, not benefits.
What happens if Congress fails to make recommendations to meet the $l.5 trillion goal? The agreement contains an enforcement mechanism that will trigger automatic cuts in 2013. These cuts would be split 50/50 between defense and non defense programs. Even if imposed, it would EXEMPT from reductions Medicaid and Social Security. Medicare could be affected in terms of limits to providers (health plans and hospitals) but not to Medicare benefits.
Bottom line: The agreement prevents deep cuts to Medicaid, the largest source of funding for treatment and support services for people living with serious mental illness. This is a tremendous victory!!
New Limits on Discretionary Spending
There will be limits on the growth of federal discretionary spending; those limits are $l.043 trillion for 2012 and $1.047 trillion for 2012. In order for Congress to increase funding for a domestic discretionary priority, an equal reduction must be made in another program to maintain the cap. Exempted are homeland security and veterans medical care.
The current budget on NIMH is $l.477 B; keeping this in place for a decade would erode the capacity for future growth in research. This is obviously a big problem, as so much more research is needed.
And, another impact will be that certain discretionary service programs operated by SAMSHA could be in danger of being cut. The programs facing danger of cuts include:
Mental Health Block Grants
PATH (outreach to homeless people)
Children's Mental Health
Various Demonstration Projects
HUD Rental assistance programs, including Section 8, Section 811, and McKinney-Vento Homeless Assistance Act
Overall: Positive protections for Medicaid, but some serious threats to effective discretionary programs- and serious limits to research in the next decade.
NOTE: Much of this material is taken from a publication by NAMI - which is posted on their web site
