Congress passes budget making it easier to repeal parts of the ACA

Vote was split mostly along party lines

The Senate on Tuesday voted 51-48 to adopt a joint GOP budget agreement that includes a provision to repeal parts of the Affordable Care Act (ACA).

The vote was split mostly along party lines, with Republicans voting in favor of the measure and Democrats voting against it. According to Reuters, GOP Sens. Ted Cruz (Texas) and Rand Paul (Ky.) were the only Republicans to oppose the measure, while Sen. David Vitter (R-La.) did not vote.

Breaking down Obama's budget: Will Medicare start negotiating drug prices?

Budget agreement details

The agreement will allow the Senate to use the budget reconciliation process to attempt to overturn parts of the ACA. Budget reconciliation allows budget bills to be passed by a simple majority. Doing so would avoid legislative hurdles that Republicans typically would need 60 votes to bypass. However, reconciliation rules prevent Republicans from using it to pass a measure repealing the entire ACA.

Under the agreement, a measure to repeal a portion of the ACA is scheduled to advance in July. According to the Wall Street Journal, Republicans could use the reconciliation measure to implement a contingency plan if the Supreme Court strikes down subsidies to help U.S. residents purchase coverage through the federal exchange. A ruling in the case is expected in June.

In addition, the budget plan assumes that the ACA's subsidies to help U.S. residents purchase coverage through the exchanges will end and the law's Medicaid expansion will be repealed. The proposal also calls for repealing tax increases that have taken place under the ACA, but it does not indicate how it would replace that revenue.

The agreement's 10-year budget plan includes more than $5 trillion in federal spending cuts, with the majority of those reductions coming from federal health care programs. For example, it would include about $430 billion in spending reductions for Medicare over the next 10 years. The proposal also calls for spending cuts to Medicaid over the next decade.

Reaction to the vote

Senate Majority Leader Mitch McConnell (R-Ky.) speaking on the Senate floor before the vote praised Congress for working to pass a joint budget agreement "for the first time in six years" that is also the first "balanced budget ... in recent memory."

However, Senate Minority Leader Harry Reid (D-Nev.) called the budget agreement "immoral," in part because it calls for "repeal[ing] Obamacare (for) 16.5 million people."

Almost 12 million gained Medicaid coverage through Obamacare

Meanwhile, White House press secretary Josh Earnest criticized the budget agreement's cuts to domestic programs, particularly when the budget calls for an increase in defense spending.

Next steps

Although the House also adopted the joint budget agreement last week, the proposal is not legally binding. Lawmakers still must pass appropriations measures to allocate funding, which could cause Republicans to compromise on some parts of the proposal if they want President Obama to sign the funding measures. Obama has said he would veto any measures with funding cuts for domestic programs.

A spokesperson for Senate Appropriations Committee Chair Thad Cochran (R-Miss.) said the panel will begin considering a dozen appropriations measures within weeks. According to the Wall Street Journal, a spending deal must be reached by Oct. 1, when the new fiscal year begins (Taylor, AP/Sacramento Bee, 5/5; Lawder, Reuters, 5/5; Timiraos, Wall Street Journal, 5/5; Bade, Politico, 5/5; Snell, Washington Post, 5/5).

The takeaway: Congress has passed a budget that will allow the Senate to use the budget reconciliation process to attempt to overturn parts of the ACA.

The 3-minute story behind Medicaid expansion

ALT TEXT

The Medicaid expansion makes for great political theatre, but there's a real story behind the drama: If, when, and how states choose to expand Medicaid has huge ripple effects on providers and patients.

FIND OUT MORE


Next in the Daily Briefing

Why most people aren't ready to answer 'What do you make?'

Read now