Budget and spending issues continue to dominate the attention of lawmakers, who are working on two different and significant levels. Both are likely to have a major impact on the funding of mental health and substance use programs and services and pose risks to Medicaid.

One area involves spending levels for the current fiscal year, which began on October 1. Because Congress has not passed any of the 12 required spending bills, it approved a temporary measure that funds the government through November 18 and avoided a government shutdown. Total spending on all funding bills for FY 2012 must not exceed $1.43 trillion—the amount set by the debt ceiling agreement that was passed last fall.

With respect to the Labor, Health and Human Services and Education appropriations bill, House and Senate appropriators are proposing vastly different levels of funding. In September, a Senate appropriations subcommittee on a party line vote of 16-14 approved a bill that would cut both SAMHSA and NIH by less than one percent, which is surprising given the current fiscal climate. The bill, crafted by subcommittee Chairman Tom Harkin (D-Iowa), demonstrates the Senate's commitment to public health and is an important marker as leaders from both chambers debate funding levels.

In the House, House Appropriations subcommittee chair Denny Rehberg (R-Mont.) introduced a bill (H.R. 3700) that would devastate public health funding, including a huge 25 percent cut to mental health programs. The brunt of the cuts in the bill would be borne by SAMHSA, which would see a reduction of 8.4 percent. That would place funding at the same level as nearly 12 years ago.

Senate leaders recently announced a plan to meld several of the less controversial appropriations bills into a single piece of legislation. It is unclear whether the House will agree to this approach and whether it will be used for other spending bills. It is possible that all the spending bills will be included in a single omnibus measure that would have to be passed before the Nov. 18 deadline or another continuing resolution extending the deadline would need to be enacted. We will be working in the weeks ahead to ensure the spending levels proposed by the Senate for public health are included in any final bill.

Another area of concern involves the work of the "Super Committee," which is a panel of 12 lawmakers created by the debt ceiling agreement charged with cutting the deficit by $1.5 trillion over 10 years. The Super Committee can consider anything that would reduce the deficit, including cutting or totally restructuring Medicaid. All six Republican members of the panel voted for Rep. Paul Ryan's (R-Wis.) budget proposal to slash federal Medicaid spending by $1.4 trillion and turn it into a block grant. As a result, Medicaid—and the crucial mental health services it funds—is vulnerable. If the panel doesn't come up with a plan by a November 23 deadline, automatic cuts would kick in, including deep and devastating cuts to vital funding for mental health services.

We will continue to press for a sound and balanced deficit plan that protects the health and welfare of our most vulnerable citizens. Please watch for updates in the weeks ahead on these issues and how you can take action to protect vital mental health services and supports.::