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GME, Bad Debt, Provider Taxes Targeted in Revised “Domenici-Rivlin” Deficit Reduction Plan

December 7, 2012—The Bipartisan Policy Center (BPC)’s Debt Reduction Task Force Dec. 3 released a deficit reduction proposal that includes $65 billion in Medicare graduate medical education (GME) cuts over 10 years.  The BPC proposal is an updated (“2.0”) version of the “Domenici-Rivlin Plan” released in late 2010.

The proposal also would “bar” Medicaid provider taxes (saves $48 billion over 10 years), replace the current Medicaid/CHIP match rates with a single “blended rate” (saves $18 billion over 10 years), and accelerate reductions in Medicare bad debt payments (saves $16 billion over 10 years). According to the proposal, teaching hospitals and other providers facing cuts under Domenici-Rivlin 2.0 “will benefit from expanded coverage from the Affordable Care Act.”

The new proposal advises against additional cuts in domestic discretionary spending, citing the 10 years of spending caps already imposed as part of the Budget Control Act of 2011 (BCA, P.L. 112-25) [see Washington Highlights, Aug. 5, 2011]. The proposal states that the authors “do not feel that any additional cuts to this area would be prudent.”


Christiane Mitchell
Senior Director Health Care Affairs
Telephone: 202-828-0461


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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806