Senate Prepares To Vote on GOP-Developed FY 2012 Budget Legislation

On Wednesday, Senate Majority Leader Harry Reid (D-Nev.) confirmed that he will schedule a preliminary floor vote on the House-approved GOP fiscal year 2012 budget resolution (H Con Res 34) when senators return next week from recess, Politico reports.

Reid did not specify a timeline for the vote, but he said that it would force Republicans to take a stand on the proposal, which has drawn mixed reactions from lawmakers (Shiner, Politico, 4/27).

Details of Budget Measure

The budget resolution seeks to cut $6 trillion in federal spending over the next decade and repeal and defund the federal health reform law.

The proposal -- unveiled by house Budget Committee Chair Paul Ryan (R-Wis.) -- also would privatize Medicare by providing beneficiaries with fixed, lump-sum vouchers to purchase private health insurance, and give states fixed annual block grants of $11,000 per Medicaid beneficiary to use as they choose (California Healthline, 4/22).

Vote an Opportunity To Show GOP Positions, Reid Says

During a media conference call to discuss the Senate's agenda for the next few months, Reid said the vote would give Senate Republicans the opportunity to indicate whether "they like the Ryan budget [plan] as much as their House colleagues did," National Journal reports. He also noted that the vote is necessary to allow the debate to move toward a final budget compromise.
The Ryan plan is likely to fail in the Democrat-controlled Senate, according to National Journal (McCarthy, National Journal, 4/27).

Reid said he "would hope" that the Senate rejects the plan because it would be "one of the worst things to happen to this country if it went into effect" (Ethridge/Friel, CQ Today, 4/27). Reid also said the proposed changes to Medicare would force beneficiaries to "go out and beg the doctor to take a voucher" (National Journal, 4/27).

Reid's statements drew strong responses from Senate GOP leaders, who questioned his motive to force a vote without offering a Democratic alternative to the Ryan plan, Politico reports (Politico, 4/27). Senate Minority Leader Mitch McConnell (R-Ky.) said Ryan presented a plan "to address our most pressing problems head-on at a moment when the president and other Democrat leaders simply refuse to do so themselves" (National Journal, 4/27).

GOP Lawmakers Re-Evaluate Message on Medicare Reform

Meanwhile, Republican lawmakers are re-evaluating their message after members recently faced questions from angry constituents about Ryan's Medicare proposal, Reuters reports (Smith, Reuters, 4/27).

During four town-hall meetings in his district on Tuesday, Ryan faced overflow crowds of supporters and protesters, many of whom angrily opposed the Medicare plan with signs that called on the lawmaker to "Leave Medicare Alone."

Using a PowerPoint presentation to contrast his proposal with the Obama administration's deficit-reduction blueprint -- which also includes a Medicare reform plan -- and the health reform law, Ryan explained that his plan would retain Medicare's benefits and strengthen the program for the future (Haberkorn, Politico, 4/26).

According to Reuters, House Republicans conducted a conference call earlier this week to discuss strategies to assure elderly U.S. residents that the proposed changes would not affect them, congressional aides said (Reuters, 4/27). National Journal reports that in order to "disarm critics," Republicans have arguing that the Ryan plan closely resembles the:

• Federal Employees Health Benefits Plan; and
• State-based health insurance exchanges that are scheduled to be implemented in 2014 under the health reform law.

However, according to National Journal, the comparisons "miss the point" because FEHB and exchanges offer "more generous" subsidies to private insurers than the Ryan plan would. The government covers 75% of the total premium cost of FEHB plan members, and the subsidies in the exchanges would depend on the benchmark costs of the plans themselves (Fernholz, National Journal, 4/27).

AARP Opposes Ryan's Medicaid Reform Plan

On Wednesday, AARP released a policy paper highlighting its criticisms of the Ryan proposal to change Medicaid to a block-grant system, The Hill's "Healthwatch" reports. The seniors advocacy group said that the proposal would impede innovation in the program and harm dual eligibles, or those who qualify for both Medicaid and Medicare, because that segment of the population would be the "obvious target" for service cuts when states' grants are depleted (Baker, "Healthwatch," The Hill, 4/27).

The group also noted that people who receive care in nursing homes could face cuts because they account for 15% of Medicaid enrollment and their costs represent 39% of the program's spending (Adams, CQ HealthBeat, 4/27).