The House Reconciliation bill passed on a 218 - 199 vote, with 16 Republicans opposing it and one Republican voting “present.” No Democrats supported it.
The bill would effectively defund large parts of the Affordable Care Act, impose more stringent eligibility reviews for Medicaid enrollees, and cap damages on medical malpractice awards — all to meet the savings targets in the House budget resolution.
The bill does not have a future in the Senate since Senate Majority Leader Harry Reid has already rejected it and the White House has threatened to veto it. However, it does give us a clear and stark picture of the debate that is already in full force.
House Budget Committee Chairman Paul Ryan (R-Wis.) said the health care cuts were necessary and reasonable, pointing out that Medicaid is expected to continue to soar over the next decade even if the GOP budget were to become law. Among other things, the proposal would:
- Prohibit Secretary Kathleen Sebelius from awarding states any more grants to set up health exchanges;
- The CO-OP program created in the ACA to provide loans to create nonprofit health insurance plans, would be defunded;
- $44 billion in premium subsidies for the newly insured would be cut;
- Medicaid's maintenance of effort requirements would be repealed;
- Medicaid disproportionate share hospital payments would be reduced, as would the match provided to U.S. territories; and
- Bonus payments payments to states that seek out and enroll low-income children would be repealed.
- The nonpartisan Congressional Budget Office estimated that more than 20 million children would face reduced food and nutrition support, almost 300,000 would be knocked off the federal school lunch program and at least 300,000 would lose access to the State Children’s Health Insurance Program.
Read this morning's New York Times for a review of the legislation.