On April 18th, the House Ways & Means Committee voted to:
- Repeal the Social Services Block Grant (SSBG). The $1.7 billion SSBG enables each state to provide social services that include special services to persons with disabilities. One of the SSBG’s five goals is preventing or reducing inappropriate institutional care by providing for home and community-based services.
- Increase repayment charges for people who receive health insurance subsidies. The Committee voted for a change in the Affordable Care Act’s (ACA) subsidies that would cause 350,000 people to forgo coverage and make it more difficult for the health reform law’s insurance exchanges to function effectively. People with low incomes who received the subsidies would be affected if their incomes increase later in the year because they found a job, received a promotion, got married, or for another such reason.
The House budget resolution directed the Energy and Commerce Committee to find $3.8 billion in savings this year. To achieve those savings, the Committee approved a separate measure on April 25th which would make significant program changes to Medicaid that would reduce federal Medicaid spending and to repeal or limit several provisions of the ACA. Among the more critical provisions are:
- Eliminating the Prevention and Public Health Fund. The ACA established this fund to expand investments in prevention and public health, to improve health outcomes, and to enhance health care quality. The ACA granted an advanced appropriation of $15 billion over its first 10 years to this fund; however, the payroll tax extension law enacted in February cut that by $5 billion. The House Committee voted to rescind the remaining money.
- Repealing the “maintenance of effort” requirements on states for Medicaid and the Children’s Health Insurance Program. The legislation would allow states to apply more restrictive eligibility standards for programs. The draft bill also would reduce the federal Medicaid match rate for U.S. territories from 55 percent to 50 percent, as well as cut the health care provider tax from the current 6 percent threshold to no greater than 5.5 percent.
- Revising the medical liability system by capping non-economic damages to $250,000,limiting attorneys’ fees and other changes. On April 17th, the House Judiciary Committee also voted to limit medical liability.
The House floor vote is currently scheduled for May 10th. However, the budget reconciliation process is not likely to proceed beyond the House of Representatives. A budget resolution, with reconciliation instructions, is unlikely to pass the Senate. For more information about reconciliation visit the Senate website. However, the existence of a concrete plan to replace the automatic cuts could give House leaders leverage in discussions about how to stop the automatic cuts that will likely occur later this year.