On-again off-again talks between the White House and House Speaker John Boehner to raise the federal debt limit broke off again when Boehner withdrew from the talks late last week. Boehner accused the President of being unwilling to address Medicare and Medicaid entitlement reforms and continued to object to revenue raising provisions preferred by the Administration. Boehner then began negotiations with Senate Majority Leader Harry Reid and Senate Minority Leader Mitch McConnell. The three parties had reached a tentative agreement on a deal that would give the Treasury borrowing authority to pay the nation’s bills through the end of the year while trimming approximately $1.2 trillion from the federal budget.  In the meantime, Congress would create a bipartisan 12 member committee made up of House and Senate members who would be tasked with finding an additional $1.6 trillion in savings. Those savings would then be wrapped into a second package to raise the debt limit. However, Obama rejected the proposal late Sunday, maintaining his opposition to any short term increases. Boehner pledged to push forward and plans to schedule a vote in the House on the two-step proposal this week.

At this point, it is not clear if an SGR fix is included in the two-step plan. The bipartisan “Gang of Six” released the framework of a plan last week which included a fully paid for repeal of the SGR and sought to find additional savings through medical liability reforms. According to press reports, House Republicans also tried to include a mechanism that would have led to the repeal of the Independent Payment Advisory Board. Many of its provisions included in the Gang of Six framework were broadly supported by members of both parties and could be included in whatever package emerges. President Obama and Treasury Secretary Tim Geithner have maintained the country would begin to default on debts if a plan is not signed into law by August 2.

Last week, the House passed The Cut, Cap and Balance Act, another proposal aimed at raising the debt limit. The legislation called for spending cuts and a constitutional amendment requiring a balanced budget. The Senate rejected the legislation days later.

CER

The Patient Centered Outcomes Institute (PCORI) has requested comments on how they should conduct comparative effectiveness research. Comments are due September 2.