Report: Effect of Ryan’s FY 2012 Budget Plan on Health Reform Unclear
It is unclear how House Budget Committee Chair Paul Ryan's (R-Wis.) fiscal year 2012 budget resolution (H Con Res 34) will affect the federal health reform law, according to a report by the Congressional Research Service, The Hill's "Healthwatch" reports.
The findings cast doubt on a promise Ryan made earlier this month that the proposal would dismantle the overhaul (Pecquet, "Healthwatch," The Hill, 4/18).
Details of Ryan's Plan
Ryan's plan would make $6 trillion in federal spending cuts over the next decade and attempt to repeal and defund the health reform law.
It also would make significant changes to Medicare and Medicaid by providing Medicare beneficiaries with lump-sum vouchers to purchase private insurance and providing states with fixed annual block grants of $11,000 per Medicaid beneficiary to use as they choose.
On Friday, the House voted 235-193, mostly along party lines, to approve the plan (California Healthline, 4/18).
CRS Report's Conclusions
However, the CRS report concluded that although the budget plan would eliminate a small number of provisions in the law, neither the plan nor a similar GOP blueprint released last year "provided sufficient detail regarding specific provisions that would be repealed or retained to determine the disposition of (numerous) provisions."
The CRS report noted that the Ryan plan would maintain the $500 billion in cuts to Medicare payments in the reform law, but the future of other provisions is uncertain. For example, it is unclear whether the new 50% discount provided by drugmakers to narrow the "doughnut hole" in the Medicare prescription drug plan would be retained or repealed under the new GOP budget proposal, according to the report.
The report also cast doubt on the future of provisions "related to the quality and efficiency of health care," such as those that:
- Create value-based purchasing programs;
- Establish quality reporting systems; and
- Implement demonstration and pilot programs for assessing various patient care models, including accountable care organizations.
The CRS report also raised questions about the effect of the new Ryan plan on the health care work force and insurance reforms, such as the newly enacted ban on denying coverage to individuals with pre-existing conditions ("Healthwatch," The Hill, 4/18).
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