GOP Begins Process To Develop Legislation To Defund Health Reform
On Wednesday, House Republicans convened the first of a series of key committee hearings to develop legislation that would defund the federal health reform law, The Hill's "Healthwatch" reports.
Lawmakers on the House Energy and Commerce Health Subcommittee and various witnesses discussed five sections of the law that have been marked for mandatory federal funding, and whether those sections should be considered mandatory or discretionary (Millman , "Healthwatch," The Hill, 3/9).
Health Subcommittee Chair Joe Pitts (R-Pa.) said the hearings are designed to "assess and prioritize all of the things that we need to do and would like to do, and then make difficult funding decisions with limited amounts of money." Pitts added that the defunding language could be attached to one of several "must-pass" bills under development in Congress, such as a bill to raise the national debt limit or the continuing resolution budget package that would fund the federal government through the remainder of fiscal year 2011 (McCarthy, National Journal, 3/9).
Funding Areas Targeted
According to Modern Healthcare, the subcommittee plans to introduce legislation to remove health reform law funding at the end of March. Earlier this month, Republicans on the full House Energy and Commerce Committee -- one of four House panels responsible for developing the defunding legislation -- identified areas in the overhaul that have been marked as mandatory funding but that they believe should be considered discretionary (Zigmond, Modern Healthcare, 3/9). Those areas are:
- Grants for state-based health insurance exchanges;
- A Prevention and Public Health Fund, slated to cost $17.75 billion over 10 years;
- A $200 million construction and capital cost fund for school-based health centers;
- State grants for sexual education and other "personal responsibility education" for adolescents, which would cost $75 million annually from 2010 through 2014; and
- Grants to establish or expand primary care residency programs in teaching health centers, which amount to $230 million from 2011 to 2015 (Pecquet, "Healthwatch," The Hill, 3/7).
These areas would require nearly $105 billion in mandatory spending over the next few years. At Wednesday's hearing, Republican lawmakers said designating the five areas as mandatory spending has made it more difficult to address the federal deficit ("Healthwatch," The Hill, 3/9).
However, some House Democrats noted that any proposal to make the funding discretionary would fail in the Democratic-controlled Senate. Rep. John Dingell (D-Mich.) added that the hearings to develop defunding language also could discourage groups from applying for funding under the reform law (Ethridge, CQ Today, 3/9).
Defunding Bills Threaten Medicare Benefits, Sebelius Warns
Meanwhile, HHS Secretary Kathleen Sebelius in a recent letter to Senate Finance Committee Chair Max Baucus (D-Mont.) warned that the House GOP's efforts to block funding for the implementation of the health reform law would threaten the benefits of millions of seniors in Medicare Advantage plans, The Hill's "Healthwatch" reports (Millman , "Healthwatch," The Hill, 3/9).
The GOP continuing resolution spending bill (HR 1) -- which the House approved in February to keep the federal government in operation through Sept. 30, the end of FY 2011 -- included several Republican-sponsored amendments to defund and block further implementation of the overhaul (California Healthline, 2/22).
Sebelius said that if the Senate passed the CR, HHS would be forced to stop all MA payments based on the new rates outlined in the overhaul (Nather, Politico, 3/9). The Wall Street Journal's "Washington Wire" reports that the overhaul gradually lowers older payment rates to insurers that administer MA plans before the rates are completely eliminated. "This would seem to mean that payment to [MA] organizations would have to be suspended, risking a significant disruption in services" to MA beneficiaries, Sebelius wrote (Adamy, "Washington Wire," Wall Street Journal, 3/9).
However, Senate Republicans dismissed Sebelius' MA payments claim. Chris Jacobs, a health policy analyst on the Senate Republican Policy Committee, issued a statement noting that the Congressional Budget Office already estimated that the House CR would not affect spending on Medicare benefits.
Jacobs also wrote that Congress cannot make any changes to Medicare, which is a mandatory spending program, through an appropriations bill for discretionary spending purposes. "HHS has all the legal authority it needs to keep the MA program (and the rest of Medicare, for that matter) up and running -- unless it wants to score political points by taking benefits away from seniors," he added (Politico, 3/9).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.