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Wednesday, Mar 18 2015

Full Issue

House GOP Lays Down Budget Marker Targeting Medicare, Medicaid; Repealing Health Law

Senate Republicans will unveil their budget plan Wednesday. Both chambers are planning to vote on their proposals next week, in hopes of approving a joint budget resolution by the April 15 statutory deadline.

House Republicans called it streamlining, empowering states or 鈥渁chieving sustainability.鈥 They couched deep spending reductions in any number of gauzy euphemisms. What they would not do on Tuesday was call their budget plan, which slashes spending by $5.5 trillion over 10 years, a 鈥渃ut.鈥 ... The plan contains more than $1 trillion in savings from unspecified cuts to programs like food stamps and welfare. To make matters more complicated, the budget demands the full repeal of the Affordable Care Act, including the tax increases that finance the health care law. But the plan assumes the same level of federal revenue over the next 10 years that the Congressional Budget Office foresees with those tax increases in place 鈥 essentially counting $1 trillion of taxes that the same budget swears to forgo. (Weisman, 3/17)

Senate Republicans are putting down a marker with their budget blueprint, one day after the House GOP unveiled a 10-year plan that boosts the military, makes deep cuts in social programs and targets President Barack Obama's laws on health care and financial reforms. Slated for release Wednesday afternoon, the GOP senators' companion measure contains greater cost cuts to Medicare 鈥 $431 billion over the coming decade, which matches Obama's savings if not his policies 鈥 but doesn't call for the dramatic transformation of the program for future beneficiaries that House Republicans are pushing. (Taylor, 3/18)

Senate Republicans, led by Budget Chairman Mike Enzi, R-Wyo., will unveil a competing budget resolution Wednesday. Both chambers are scheduled to vote on their plans next week, with a goal of passing a joint budget resolution by the April 15 statutory deadline. (Davis, 3/17)

House Republicans released a 2016 spending blueprint Tuesday that seeks to fulfill the GOP goal of balancing the budget in 10 years, but does so by slashing Medicare and other safety net programs while dramatically boosting military spending. The proposed annual budget, at $3.8 trillion, promises to lower taxes and revisits well-worn Republican ideas for shrinking government, including its signature proposal for overhauling Medicare with a voucher-like private insurance option. (Mascaro, 3/17)

The [House] plan uses a budgetary maneuver, already contentious, designed to address the concerns of both defense hawks worried about curbs in military spending and deficit hawks uneasy over waning fiscal discipline. It would boost military spending through the use of emergency war funds that aren鈥檛 subject to congressionally mandated spending caps, known as the sequester. ... The budget blueprint maintains last year鈥檚 overarching focus on eliminating the deficit, with savings also generated by a repeal of the Affordable Care Act. It relies on several policy proposals introduced in recent Republican budgets. (Timiraos and Peterson, 3/17)

The plan, which pares more than $5 trillion from the federal budget, will instantly renew long-running hostilities with the White House and Democrats regarding spending and debt. But the biggest clash is likely to be between GOP budget hawks determined to reduce spending and defense hawks who want to bolster the Pentagon in the face of rising threats from the Islamic State and other terrorist groups. (Kane and Wilson, 3/17)

[House Budget Committee Chairman Tom] Price is also projecting $2 trillion in savings over the next decade from repealing the 2010 Affordable Care Act, according to documents provided by the Budget Committee. That, of course, is not going to happen while Obama is still in the White House. Another $913 billion in savings would come from turning Medicaid into a block grant program, as well as changes to other federal health programs. Those proposals will run into strong objections from Democrats and the Obama administration as well. In addition, Price is estimating more than $1 trillion in cuts to other 鈥渕andatory鈥 or entitlement programs, including food stamps. The federal food stamp program, formally known as the Supplemental Nutrition Assistance Program, would be turned over to state control starting in 2021. (Bresnahan, 3/17)

The Republican proposal would leave Social Security untouched and reduce projected spending on Medicare by 2 percent over 10 years while making steep cuts in projected spending for Medicaid and other health programs and eliminating all spending for the Affordable Care Act. ... It was a contrast to the budget Obama proposed Feb. 2, which seeks to boost middle-income families through new programs paid for by more taxes on wealthy Americans. Obama would also use a one-time tax holiday to bring home foreign earnings in order to pay for major infrastructure spending. His plan would not balance the budget, instead leading back to $1 trillion-plus annual deficits. (Hall, 3/17)

The spending plan stands little chance of ever being signed by President Obama, but makes clear that the party is not dialing back its ambitions despite a rocky start to the latest congressional session. After some internal debate over the Republican strategy for taking on the Affordable Care Act, the budget plan renews GOP calls to repeal and replace the law. (3/17)

Meanwhile, in the background -

A new round of cuts to a popular program that provides health care to seniors will touch off a spate of partisan finger-pointing in the coming weeks, handing Republicans a new opportunity to blast the Obama administration. The Centers for Medicare and Medicaid Services is expected to announce in April how much it will cut from payments in 2016 to health insurers for Medicare Advantage, the popular program that covers seniors through private HMO and PPO plans. CMS in February recommended a 0.9 percent cut, though the agency may cut up to 0.95 percent, which would result in seniors paying higher premiums. (Wilson, 3/17)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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