NASL Article Details



General Announcement

Budget Proposals Overhaul Health Care with Repeal of the ACA

NASL, 4/2/2015


The U.S. House of Representatives and U.S. Senate passed Fiscal Year (FY) 2016 budget resolutions that make policy statements about future objectives, including deficit targets. On March 25, the House approved its budget resolution (H. Con. Res. 27) by a 228-199 vote. The Senate approved its proposal (S. Con. Res. 11) March 27 by a 52-46 vote. 

The resolutions are high-level road maps intended as frameworks for legislative action and are not binding on Congressional committees or appropriators. These resolutions allocate spending among broad budget functions, and do not go to the President for signature. Typically, budget resolutions make policy statements about future actions and objectives, including deficit targets. Also, they can include reconciliation instructions that direct 
Congressional committees to produce bills that would change spending and revenue laws to meet the budget resolution targets.

Both plans are aiming for balanced budgets by 2025, with the majority of deficit reduction coming from health care reform spending cuts. The House budget resolution calls for $5.5 trillion in reductions – $2 trillion from repeal of the Affordable Care Act (ACA); $148 billion from Medicare; $913 billion from Medicaid on the mandatory spending side and $759 billion from domestic discretionary spending. The House resolution would partially privatize Medicare by creating a premium support system in 2024, while maintaining traditional Medicare as an option. It also turns Medicaid into a block grant program and repeals the Affordable Care Act. The Senate resolution would repeal the ACA, but not privatize Medicare. The proposal would repeal the medical device tax and extend “certain” expired provisions. The Senate resolution also would cut unspecified savings by $430 billion over a decade.

Both resolutions would permit “reconciliation” – a process that allows for expedited consideration of deficit-reduction legislation. The budget plans can only specify targets for such later reconciliation bills, and not how they would be used.
The House resolution seeks deficit-reduction recommendations from 13 Committees, which were told to note the Committee report’s proposals on the ACA. The Senate resolution’s instructions request deficit-reduction ideas from two Committees – $1 billion each from the Senate Finance and Health, Education, Labor & Pensions (HELP) Committees, which share oversight of the health-care law. 

House Budget Committee Chairman Tom Price (R-GA) and Senate Budget Committee Chairman Michael B. Enzi (R-WY) have said that they hope to resolve the differences in their budget plans by April 15, the target date set by the Congressional Budget Act. Getting the budget resolutions adopted in each chamber and then ironing out the differences to get to a conference report
 – something that hasn't happened under Republican control since 2005 – is necessary for setting up later legislation that would include the health care cuts, and that could ultimately be sent to The White House.