Senate Votes to Avoid Fiscal Cliff, House Decision Expected Tuesday

Failure to reach agreement could have significant impact on health care in U.S.

TUESDAY, Jan. 1, 2013 (HealthDay News) -- The U.S. Senate did its part early Tuesday to steer the country clear of the so-called fiscal cliff, with an 11th-hour agreement to head off widespread tax increases and spending cuts set to kick in Jan. 1.

But the final step is up to the House of Representatives, which is expected to vote on the measure Tuesday. Many Republicans' opposition to tax increases and a desire for steeper spending cuts make it difficult to predict the vote's outcome.

"This shouldn't be the model for how to do things around here," Senate Republican leader Mitch McConnell of Kentucky said just after 1:30 a.m. Tuesday, The New York Times reported. "But I think we can say we've done some good for the country."

McConnell worked with Vice President Joseph Biden to secure the Senate's 89-8 vote. He recommended that the entire Congress act quickly to pass the legislation and "continue to work on finding smarter ways to cut spending" in the coming months, the Associated Press reported.

After the Senate vote, Biden said, "You surely shouldn't predict how the House is going to vote. But I feel very, very good."

The bill approved by the Senate would prevent a 27 percent cut in fees paid to doctors who treat Medicare patients. It would also block middle-class taxes from going up but would raise taxes on wealthier Americans. And it would delay legislatively mandated spending cuts for two months, among other measures, the AP reported.

Failure to reach agreement on spending cuts could have a significant effect on health care in the United States, according to Kaiser Health News.

For instance, Medicare providers would see a 2 percent across-the-board payment cut, or $11 billion in fiscal year 2013. According to a September report from the Office of Management and Budget, hospitals would be hit hardest by the cuts, with payments slashed by about $5.8 billion, Kaiser Health News reported.

Seniors would experience no changes in their benefits, however, and Medicaid would not face any automatic cuts come Jan. 1.

The National Institutes of Health would have to contend with a $2.5 billion cut in funding for 2013, which would mean the agency would "have to halt or curtail scientific research," according to the OMB analysis.

Other federal agencies would face funding cuts as well, such as the Centers for Disease Control and Prevention ($490 million), and the Food and Drug Administration ($318 million), Kaiser Health News said.

Dr. David Katz, director of Yale University School of Medicine's Prevention Research Center, tried to put the debate over the fiscal cliff and its potential impact on health care in layman's terms.

"To some extent, talk of a 'fiscal cliff' and its implications can seem remote. But there is a very personal element to all of this. If Medicare reimbursement is slashed, the federal government will, in essence, be cutting the income -- along with raising the taxes -- of physicians who don't work for the federal government. This certainly makes Washington gridlock personal for all of my fee-for-service colleagues. If they, in turn, translate resentment of this heavy-handed imposition into practice, this may get personal for Medicare patients who have a harder time accessing care."

And, he added, "massive cuts to the NIH (National Institutes of Health) budget may seem remote and impersonal -- unless the research that isn't funded as a result would have saved your life, or that of someone you love. Cuts to CDC (the Centers for Disease Control and Prevention) may seem remote -- unless you are a victim of a neglected disease outbreak, or of a preventable chronic disease no longer the focus of research and programming.

"And cuts to the FDA (Food and Drug Administration) budget may be someone else's problem, until the drug you need is languishing in the approval process; a drug is approved that should not have been and imposes its toxicity on you; or the uninspected food on your table is a vehicle for salmonella or E. coli," Katz said.

More information

For more on how the so-called fiscal cliff might affect health care in the United States, visit Kaiser Health News.

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