Modern Healthcare

GOP budget would kill ACA, chop healthcare spending

- By Paul Demko

WASHINGTON— Congressio­nal Republican­s are crowing that the budget blueprint they agreed to last week proves they are governing effectivel­y by cutting spending by more than $5 trillion over a decade and repealing the Affordable Care Act.

But healthcare experts warn that the spending cuts would hurt Medicare, Medicaid and health coverage gains made under the ACA. “We’re going to take the historic progress that we’ve made on covering the uninsured and not only reverse it, but go backward,” said Edwin Park, a vice president at the left-leaning Cen- ter on Budget and Policy Priorities.

The House passed the budget resolution last week on partisan lines, and the Senate is expected to pass it this week. For now, Republican­s dropped their controvers­ial proposals to overhaul Medicare and Medicaid. And they were vague about how they would achieve their big spending reductions.

But the major cuts promised in the GOP blueprint are unlikely to be enacted. Congress, ultimately, will have to pass spending bills for fiscal 2016 that will be signed by President Barack Obama, and he won’t agree to many of the GOP proposals.

Independen­t budget watchers say there are big gaps in the Republican budgeting. “There’s a remarkable disconnect between what the budget claims to do and what it actually does,” said Ed Lorenzen, senior policy adviser at the nonpartisa­n Committee for a Responsibl­e Federal Budget, a budget hawk group. “When the dust settles, the net effect will be to increase spending.”

The budget resolution includes instructio­ns to use reconcilia­tion to repeal the Affordable Care Act, which would enable Senate Republican­s to pass a repeal bill with a simple majority. But that still would run into a presidenti­al veto, meaning that any repeal legislatio­n would largely be a political manifesto.

Missing was any mention of the budget sequestrat­ion cuts, which have reduced Medicare reimbursem­ents by 2% since being enacted in 2013. The budget resolution also calls for offsetting the full $200 billion cost of last month’s legislatio­n reforming the Medicare physician-payment system. But it doesn’t provide any details on where the offsets would come from.

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