The debt ceiling debate currently consuming the halls of Congress has wide-ranging implications for the economy generally, employers large and small, and a number of specific industries, including health care. Congressional leadership and the Obama Administration are in closed-door negotiations, considering how to raise the debt limit, and determining what spending cuts and tax adjustments are needed upfront in order to reach agreement between the two parties and gain the votes needed to pass comprehensive legislation. The Congressional committees largely responsible for determining policies in relation to health care, tax and finance, and other programs, are not putting recommendations and proposals together. Rather, the process is being driven by the numbers – meaning, the effort is to come up with an achievable level of savings and/or revenue growth that can garner support for raising the debt ceiling. This is problematic in many ways, as the officials making decisions do not necessarily understand the impact their decisions on program cuts, such as Medicare cuts, will have on health care organizations and providers. Several sectors of health care have had to accept significant cuts as a result of the health care reform law, and at a time when those cuts and changes are only just beginning, it’s difficult for the industry to accept that they may face additional significant cuts through a debt negotiation deal.