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There are a few weeks left for this Congress to finish its business by December 31.  The biggest issues (and most consequential) involve “sequestration” and “the fiscal cliff.”  But what does it all mean and what are the implications?  We’ve put together an all-you-need-to-know guide about the fiscal cliff, including sequestration and its potential impact on women’s health.

7 Questions About Sequestration and the Fiscal Cliff


  1. What exactly are the “fiscal cliff” and “sequestration” and why is everybody talking about them?  

    The fiscal cliff is a term used to describe the combination of expiring policies, including the Bush tax cuts, Obama payroll tax cuts, and the impending sequestration (across the board budget cuts) set to take place January 2.  If the government allows tax rates to increase, in conjunction with cuts to major government programs, it could seriously affect the economy and job growth throughout the country. 

    “Sequestration” is a one-word term for “sequester cuts” — draconian budget cuts split 50-50 between defense and non-defense spending, with exemptions for Medicaid and Social Security among others.  These across the board cuts begin in January 2013 unless Congress passes a bill to prevent them.  While important programs like Medicaid and Social Security are exempt, the impact of these cuts will severely undermine our nation’s health care infrastructure.  In fact, according to an official Office of Management and Budget (OMB) report on sequestration, there is “no question that the sequestration would be deeply destructive to national security, domestic investments, and core government functions.” 
  2. Why is it happening now?

    Remember that “super committee” last year?  They were a bipartisan group of 12 senators and House members tasked with finding a budget solution that reduces the deficit by $1.2 trillion over 10 years.  When they failed to come up with a deal, these automatic across the board cuts (also referred to as sequestration) were triggered.  These cuts on spending for both defense and non-defense programs, including the Title X family planning program and grants under the Affordable Care Act (the health care law), will go into effect on January 2, 2013.  One thing everybody agrees on is that they do not want the sequestration to take effect.
  3. What is the potential impact of sequestration?

    If the sequestration cuts take effect, quite simply, the impact will be severe.  The specifics of what gets cut from each program are unclear, but some estimate the Title X family planning program, which provides affordable preventive care to more than five million people each year, would face up to $24 million in funding cuts, bringing overall funding down to $270 million.  Other women’s health programs like affordable chlamydia screening programs for low-income women that help prevent infertility could face steep cuts as well.
  4. So, what happens next?

    It’s now up to Congress and the White House to develop a plan that avoids these detrimental cuts while still tackling our nation’s deficit.  Some speculate that Congress can fully address both by coming up with a new budget deal during the post-election session, while others have suggested they punt and defer responsibility to the next Congress which starts in January.  Either way, if this Congress takes action to prevent sequestration (as many expect), it will trigger a renewed legislative debate over proposals to reduce the deficit — a debate that women and families have a huge stake in.  And if they don’t, cuts to important programs like Title X and grants under the Affordable Care Act grants will take place.

    In any budget debate, our priority is to protect women’s health care programs, including Medicaid, the Affordable Care Act, and the Title X family planning program.

  5. Who is working to prevent sequestration?

    Right now, the White House and congressional leaders are working closely together to broker a deal.  At some point, more members of Congress will be engaged (as they have to vote for it!).  But no matter who is in the driver’s seat, it matters most how much they hear from people in America about their priorities.   
  6. If politicians avoid the fiscal cliff, including sequestration, through budget negotiations, what’s the potential impact on women’s health programs?
    If the fiscal cliff, including sequestration, is avoided, that means Congress and the White House have to come up with a new deal to reduce the deficit — which means we will have to work hard to protect the programs that women and families rely on most, including Medicaid and the Affordable Care Act.  While many programs that Planned Parenthood patients rely on could be affected by the ongoing budget debate, the Affordable Care Act is most at risk for funding cuts.  This includes cuts to women’s preventive health benefits as well as insurance coverage subsides that provide a way for low-income people to buy health insurance.  Already more than 45 million women have received preventive care like lifesaving cancer screenings, well-woman exams, and Pap tests with no co-pay under the Affordable Care Act, and under the law, access to affordable health insurance will become available for the nearly 13 million women of reproductive age who will be newly eligible for insurance coverage.  These are just some of the benefits that could be cut if politicians make cuts to the health care law during budget negotaions.

    Also, potentially at risk is the Medicaid program which provides health coverage for approximately 60 million people, and with Medicaid expansion set to begin in 2014 under the Affordable Care Act, the number of people covered will only increase.  Needless to say, it’s not a small line-item in the budget.  Because of the price tag, policymakers who are looking for places to make significant cuts in spending may look to Medicaid.

    Right now one in 10 women relies on Medicaid for her health care needs.  Hispanic Americans account for 29 percent of Medicaid enrollees, and black Americans account for one in four.  For women, Medicaid can mean the difference between getting cancer screenings and birth control, or going without.  Currently, Medicaid protects women’s access to family planning by ensuring coverage and giving women the ability to choose their own health care provider.  There are a number of proposals out there that could restructure and redefine how the program functions — but many of these proposals could reduce access and cause women to lose these important benefits.

  7. What is Planned Parenthood fighting for? 

    Planned Parenthood is fighting for all programs that expand access to health care, especially for women.  The Affordable Care Act is the greatest advancement for women’s health in a generation — expanding health care for millions of women, including access to birth control with no co-pay and preventive care like lifesaving cancer screenings.  Medicaid, the Title X family planning program, and the CDC infertility prevention project are crucial lifesaving programs for women’s health.  For millions of women, Medicaid and Title X make the difference between access to cancer screenings and birth control or going without.  It’s especially important that Congress protect these programs because investing in family planning programs not only saves lives, it saves taxpayers money.

    With potential cuts on the table, it is more important than ever to raise awareness about what is at stake for women’s health and the important preventive services Planned Parenthood provides.

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