Senate Votes Along Party Lines To Pass GOP’s FY 2016 Budget Plan

The Senate on Friday voted 52-46 to approve Republicans' fiscal year 2016 budget proposal, which includes changes to federal health programs and a provision to repeal the Affordable Care Act, the New York Times reports (Weisman, New York Times, 3/27).

According to AP/Los Angeles Times, the vote to approve the measure occurred along party lines, with all but two Republicans voting in favor of the proposal and all Democrats voting against it (AP/Los Angeles Times, 3/27).

Proposal Details

The proposal calls for more than $400 billion in Medicare savings over 10 years but does not provide many specifics on how those savings would be achieved. Instead, the plan tasks individual Senate committees with jurisdiction over Medicare to find such savings. The plan would not transition Medicare into a "premium support" model, unlike the House GOP proposal.

Also in contrast to the House proposal, the Senate's plan would not convert Medicaid into a block grant program. Instead, it calls for states to have more flexibility in running Medicaid programs by administering Medicaid, similar to CHIP. Meanwhile, it calls for about $400 billion in Medicaid savings over a decade.

The Senate budget plan would task the Senate Finance and Senate Health, Education, Labor and Pensions committees with proposing at least $1 billion in savings by July 31 for legislation that could be passed via reconciliation.

According to Senate budget committee sources, the $1 billion target was set intentionally low to provide for flexibility based on whether the Supreme Court strikes down subsidies to help U.S. residents purchase coverage through the federal exchange in King v. Burwell. The high court heard oral arguments in the case earlier this month and is expected to release a decision by the end of June.

The Senate budget document states that because a ruling striking down the federal exchange subsidies "could significantly alter the levels of spending in the budget resolution ... the Senate Republican budget includes reconciliation instructions for health care, but the actual contours of that legislation are unknowable at this time."

In addition, the proposal includes amendments that would:

• Create a deficit neutral fund to bolster VA's Veterans Choice Card program;
• Establish a deficit neutral fund to allow VA to hire more mental health care workers and help to make sure veterans receive care in a timely manner;
• Establish a deficit neutral fund to increase integrated and coordinated care for children in Medicaid who have "medically complex" conditions; and
• Protect Medicaid beneficiaries from benefit cuts (California Healthline, 3/26).

Lawmakers Offer More Amendments

Lawmakers offered various amendments to the budget proposal during a "marathon" series of votes on the plan, The Hill's "Floor Action" reports.

The Senate approved an amendment, offered by Democrats, that would require U.S. employers to offer employees up to seven paid sick days (Carney/Shabad, "Floor Action," The Hill, 3/27). According to the Washington Post, the amendment is deficit neutral. The measure was backed by six Republicans (Sullivan, Washington Post, 3/27). Overall, the amendment passed with a 59-41 vote (Carney [1], "Floor Action," The Hill, 3/26).

In addition, the chamber approved another Democrat-sponsored amendment that would allow legally married same sex couple to have equal access to benefits from Social Security and VA (Carney/Shabad, "Floor Action," The Hill, 3/27). That measure was backed by five Republicans (Washington Post, 3/27).

The chamber also voted 56-44 to approve an amendment offered by Sen. Tim Scott (R-S.C.) to create a deficit-neutral fund that would increase awareness of all ACA-related taxes included in monthly health insurance premiums (Carney [2], "Floor Action," The Hill, 3/26).

However, the chamber voted 47-53 to reject an amendment introduced by Sens. Susan Collins (R-Maine) and Ron Wyden (D-Ore.) that would have restored more than $1.2 trillion in Medicaid cuts (Carney [3], "Floor Action," The Hill, 3/26).

Reaction

Senate Budget Committee Chair Mike Enzi (R-Wyo.) applauded the proposal as one that would "protect the nation's most vulnerable citizens, strengthen national defense and bring robust economic growth" (New York Times, 3/26).

Senate Majority Leader Mitch McConnell (R-Ky.) said, "By passing a balanced budget that emphasizes growth, common sense and the needs of the middle class, Republicans have shown that the Senate is under new management and delivering on the change and responsible government the American people expect."

However, Democrats in the chamber criticized the proposed budget for including a provision to repeal the ACA and giving states more control over Medicaid (Peterson/Crittenden, Wall Street Journal, 3/27). Senate Minority Leader Harry Reid (D-Nev.) said, "Fortunately for the country, the Republican budget will not become law."

Next Steps

The House on Wednesday passed its own GOP budget plan. Senate and House negotiators now must work on a comprise budget bill (New York Times, 3/27).

According to Reuters, if lawmakers pass a combined budget next month, Republicans could use parliamentary rules to repeal the ACA in the Senate with a simple majority vote, rather than the 60-vote threshold normally required (Lawder, Reuters, 3/27).