Two Months Out Sequester Results Are Uneven
On March 5 my Daily Local News column discussed the impact of the federal government sequester on seniors. Now, almost two months later we are beginning to see the effects. As one example, while the Department of Veterans Affairs was itself exempted from the cuts, as matters play out, Veterans themselves are not necessarily unaffected. Depending on the services needed and the agencies through which the services are offered, Veterans are beginning to feel the bite. Also, in an unexpected turn of events, cancer patients might find they are unable to access clinics specifically for cancer treatments and may need to receive chemotherapy at hospitals instead. Hospital care, ironically, will be at greater cost to the government.
If there is a generalization that can be made about the sequester, the automatic $85 billion funding cut half from domestic programs and half from defense, it is that the results are uneven. At this point, it appears that those who shout the loudest, have the greatest political influence, and, ideally, direct affect Congress are the most likely to win a race to obtain exemptions. For instance, when the Federal Aviation Administration initiated furloughs of air traffic controllers on April 21, the process took six days to reverse course. Each day the agency released a press release and tweeted about the number of flights delayed due to sequestration. National news broadcasts showed footage of flights cancelled at major airports. According to the National Journal, www.nationaljournal.com, flights were delayed at airports including New York, Washington, DC, Cleveland, Dallas and Jacksonville, FL. Congress and the President relented last week and approved flexibility in implementing the cuts for the FAA. Meat inspectors employed by the government Department of Agriculture received similar flexibility in March based on public safety considerations although other DOA employees did not.
For Veterans, programs supporting them from housing to mental health that are handled by agencies other than the Veterans Administration are subject to the cuts and do not receive the benefit of the exemption received by the agency overall. Here are some examples.
The US Department of Labor operates a VETS job-training program especially directed to recent Vets following 9/11. Cuts are expected to this program and to another, the Jobs for Veterans state grants program.
Administrative funding is being cut for Housing and Urban Development programs that provide vouchers for homeless veterans.
According to a recent article in the Washington Post, “VA Dodges Budget Cuts, But Veterans Will Still Feel Effects of the Sequester,” March 8, 2013, forty percent of the Defense Department’s medical providers working at military hospitals and clinics are civilians subject to furlough and 44 percent of the Defense Department’s 800,000 civilian employee workforce are Veterans in the Department which is also subject to the sequester.
Military pay is exempt from sequestration. However, programs such as TRICARE, tuition assistance and family support programs are not exempt and can be reduced under sequestration. See “Top 10 Fiscal Cliff FAQs,” www.militaryadvantage.military.com. Top concerns listed by Military Advantage in its interview of the Chairman of the House Veterans Affairs Committee and House Armed Services Committee are backlog in processing military disability claims, the VA mental health care crisis, and opportunities for veterans to find employment. It was also reported that layoffs are expected in the private sector as defense contracts are reduced or suspended.
In an unexpected turn of events relating to the sequester, the way that Medicare pays for cancer clinic treatment has disproportionately affected cancer patients who receive chemotherapy outside a hospital setting. Because cancer drugs are expensive and must be administered by a physician under Medicare Part “B,” clinics are faced with a 2% reduction under the sequester that they say they are unable to absorb. Payment is based on the cost of the drug plus a percentage. If treatment were received in a hospital, this would be under Medicare Part “A” without similar restrictions. The cost of the drugs, as reported by the clinics, cannot be bargained away which leaves them with choices as to what needs to be done with staff. Some clinics have begun turning patients away who receive the highest cost medications.
For other sequester effects, it is worth noting that Social Security benefits and Medicare benefits are not affected, although Medicare has the 2% reduction to providers. As employees are on furlough in many government departments, it may be more difficult to get answers to questions and more time consuming to process claims.
About the Author Janet Colliton
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.