![Page 1: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/1.jpg)
The First Cut Is The Deepest?
Federal Spending Cuts 2011 – 2014
![Page 2: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/2.jpg)
Background FY2013
Social Security
Mandatory Health Programs (Medicare, Medicaid, SCHIP)
Other Mandatory (Military retirement, , etc)
Security (Defense, VA, Homeland Security)
Non-Security Spending
![Page 3: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/3.jpg)
Can we cut our way to prosperity?
0
100
200
300
400
500
600
700
800
900
Deficit projected to accrue over FY 2013 Non-Security Spending in FY 2013
![Page 4: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/4.jpg)
Deficit Reduction to Date • FY 2011 and FY 2012 bills lowered discretionary spending by
$550 million over 10 years. • The Budget Control Act (BCA) further lowered discretionary
spending by $900 billion.
• The American Taxpayer Relief Act (ATRA) cut discretionary spending by another $14 billion.
• ATRA raised $617 billion in revenues.
• Interest savings from these 3 actions = $300 billion
![Page 5: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/5.jpg)
Total Deficit Reduction
$2.4 trillion BEFORE SEQUESTRATION
$1.7 billion in cuts to discretionary spending
$700 billion in raised revenue
![Page 6: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/6.jpg)
Let’s Talk About Sequestration for a
minute….
![Page 7: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/7.jpg)
Details Matter… • Continuing Resolution for discretionary $ ▫ Estimated 5% cut at the account level ▫ Additional Flexibility = 1% 3% transfer ▫ Operating Plans due 30 days after enactment
• Prevention Fund ▫ Estimated 7.8% cut = -$78 million ▫ Total flexibility
![Page 8: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/8.jpg)
Prevention Fund Uses FY 2012 • ½ the Fund goes to 3 activities: Community
Transformation Grants; Section 317 Immunization; and Tobacco Prevention and Control
• ¼ of the Fund goes to core State health operations like epidemiology, screening campaigns, surveillance, etc.
• The remaining ¼ goes to a variety of initiatives like Alzheimer’s Disease Self Management, Prevention Research Centers, Primary and Behavioral Health Integration, etc.
![Page 9: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/9.jpg)
• The Senate Budget resolution replaces sequestration with a mix of spending reforms and revenue provisions.
• The House Budget resolution implements sequestration BUT:
▫ Moves the defense cuts to the non-defense budget.
Sequestration here to stay?
![Page 10: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/10.jpg)
Competing Visions of the Future
0
100
200
300
400
500
600
700
2013 2014 2015 2016 2017 2018 2019 2020 2021
Non-Defense Spending
BCA pre-sequestration Non-defense
BCA post-sequestration Non-defense
House Budget Non-Defense
Senate Budget Non-Defense
![Page 11: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/11.jpg)
Details Matter…. In current law, there is an $12 billion emergency
fund for major natural disasters. The House Budget eliminates that fund, so any
major emergency responses in the next 10 years would need to be offset with additional discretionary cuts.
![Page 12: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/12.jpg)
Close Up on FY 2014….
$0
$200
$400
$600
$800
$1,000
$1,200
FY 2014 BCA pre-seq FY 2014 BCA post-seq FY 2014 House FY 2014 Senate
Jobs/Infrastructure
Disaster
Non-Defense
Defense
![Page 13: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/13.jpg)
Some of us like to see the numbers…
Dollars in Billions
FY 2013 FY 2014 BCA pre-seq
FY 2014 BCA post-seq FY 2014 House FY 2014 Senate
Defense $552 $552 $497 $552 $552
Non-Defense $491 $506 $469 $414 $506
![Page 14: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/14.jpg)
Did you do the math??? • House budget for non-security spending: ▫ a 16% cut from FY13 (-$77 billion) AKA
▫ an 11% cut (-$55 billion) below the FY14 level after sequester is already subtracted (-$22 billion).
• For comparison: ▫ CDC’s discretionary budget is $5.6 billion. ▫ The total FY14 Prevention Fund is $1 billion. ▫ The entire cost of operating Medicare and
Medicaid for a year is $3.8 billion.
![Page 15: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/15.jpg)
Timeline for Action…. • March 27th: FY 13 will be finished.
• Mid-April: HHS agencies will be required to submit operating plans for all FY13 spending no later than 30 days after FY13 bill passes.
• April 15th: Deadline for budgets to be passed in both House and Senate.
• April – May: Hearings on HHS budget
• May 10: Senate LHHS deadline for requests
![Page 16: The First Cut Is The Deepest? - Dialogue4Health · The First Cut Is The Deepest? Federal Spending Cuts 2011 – 2014](https://reader031.vdocuments.us/reader031/viewer/2022021823/5b42d4497f8b9ab15f8b6123/html5/thumbnails/16.jpg)
Federal budgets aren’t cute. Puppies are. Thank you for listening.