Months after promising voters they would repeal Obamacare, House Republicans in three committees have introduced proposals to roll back specific parts of President Obama’s health care law.
But the plans stop short of a full repeal.
Three committees in the House—Ways and Means, Energy and Commerce, and Education and the Workforce—approved proposals last week detailing what provisions of Obamacare will be repealed through a budget tool known as reconciliation.
“With contributions from three House committees, this reconciliation package will give American families the relief they need from such a disastrous law,” Ways and Means Chairman Paul Ryan said in a statement. “It’s time to confront the president with the failings of Obamacare, and that’s just what this bill will do.”
In addition to repealing parts of President Obama’s health care law, the Energy and Commerce Committee’s reconciliation plan includes a provision to strip Planned Parenthood of its federal funding—a plan that has raised serious doubts among scholars on the left and the right.
The committee’s plan directs the roughly $235 million Planned Parenthood receives through Medicaid reimbursements to community health centers.
Reconciliation is a budget tool that fast-tracks legislation and requires just 51 votes in the Senate to pass, a simple majority. Democrats used reconciliation to pass Obamacare in 2009, and many Republicans campaigned on rolling back the health care law during the 2014 midterm elections.
Republicans included broad reconciliation instructions that addressed Obamacare in its budget resolution, which passed both the House and Senate several months ago. But conservatives argue that such instructions were included in exchange for their support of the budget document.
As some Republicans began to discuss using reconciliation to address issues like tax reform and Planned Parenthood after the budget resolution was passed, conservative lawmakers pushed for Republican leaders to fulfill their promise to both their GOP colleagues and voters and use the tool to fully repeal Obamacare.
Now, the three reconciliation proposals repealing parts of the law that were passed by their respective committees will be reviewed by the House Budget Committee and packaged together before lawmakers vote on the House floor.
Still, some conservatives disagree with the three plans addressing Obamacare and continue to push for the law to be completely rolled back.
During the recent debate over Planned Parenthood, Rep. Mark Walker, R-N.C., circulated a letter among his Republican colleagues that encouraged leadership to bring a reconciliation bill repealing Obamacare to a vote. Now, Walker is pushing back against the plans from the Ways and Means, Energy and Commerce, and Education and the Workforce Committees, saying they don’t go far enough.
“During the 16 public forums I have held in my district this year, I promised my constituents that I would do everything in my power to repeal Obamacare,” he said in a statement to The Daily Signal. “Unfortunately, the proposal before us does not deliver on the full Obamacare repeal promise that we as Republicans gave the voters during the past two election cycles.”
Sen. Mike Lee, R-Utah, also spoke out against the House plans and said in a statement to The Daily Signal that the reconciliation language falls short of fulfilling the promises Republicans made to voters.
“The House reconciliation bill repeals only seven of Obamacare’s 419 sections. This is not what Republicans promised the American people we would do,” Lee said. “It’s time that Republicans in the House and Senate honor this promise we all made to the American people. It’s time to pass a reconciliation bill that repeals as much of Obamacare as possible.”
Each of the individual reconciliation proposals approved by the Ways and Means, Energy and Commerce, and Education and Workforce Committees repeals different provisions of Obamacare.
The Ways and Means Committee’s reconciliation language targets five parts of the health care law: the individual mandate, the employer mandate, the “Cadillac” tax, the medical device tax, and the Independent Payment Advisory Board, a 15-member board that addresses Medicare’s solvency.
According to a report from the Congressional Budget Office and Joint Committee on Taxation, repealing these five provisions of the law would reduce the deficit by $37.1 billion over a 10-year window, from 2016 to 2025.
The CBO reported that the majority of the savings would come from a decrease in enrollment in health insurance plans among consumers who qualify for Obamacare’s tax credits.
In addition to placing a one-year moratorium on Planned Parenthood’s funding, the Energy and Commerce Committee’s reconciliation language repeals the provision of Obamacare that created the Prevention and Public Health Fund, which funds grants awarded by the Department of Health and Human Services to organizations and institutions addressing public health issues.
The Energy and Commerce Committee’s reconciliation language calls for the funds remaining to be rescinded.
According to the Congressional Budget Office, the committee’s reconciliation proposal would decrease spending by $12.4 billion.
The last committee to submit a reconciliation proposal, Education and Workforce, targets provisions of Obamacare that address enrollment of employees in employer-sponsored coverage.
The health care law amended the Fair Labor Standards Act to require employers with more than 200 full-time employees—defined as those working more than 30 hours per week—to automatically enroll new employees in a health insurance plan they offer. Under Obamacare’s employer mandate, businesses with more than 50 employees must provide their workers with health insurance.
Additionally, employers must automatically enroll workers in a plan if the employees don’t choose coverage they receive.
Republicans argue that the auto-enrollment requirement pushes employers to enroll employees in unnecessary health insurance plans.
Rolling back the provision, as the Education and Workforce Committee calls for in its reconciliation language, would reduce the deficit by $7.9 billion, the Congressional Budget Office estimated.
Pushback From Scholars
Though Republicans pushed for reconciliation to be used to address both Obamacare and federal funding for Planned Parenthood, scholars on both sides of the aisle argue that reconciliation cannot be used to strip the organization of its federal dollars.
Paul Winfree, director of the Thomas Roe Institute for Economic Studies at The Heritage Foundation, and Molly Reynolds, a fellow in governance studies at The Brookings Institution, agree that reconciliation may not be used to defund Planned Parenthood because the provision violates the Byrd Rule.
Under the Byrd Rule, senators can object to provisions of a reconciliation bill that don’t change revenues or spending. Senators can object to a specific part of the legislation that they feel includes “extraneous matter,” and, if the Senate parliamentarian agrees, the questionable provision is then stricken from the bill.
Additionally, according to Winfree, reconciliation bills cannot change discretionary spending, which poses a problem for those wanting to use the budget tool to defund Planned Parenthood. The organization receives approximately $60 million through the Title X Program, which qualifies as discretionary spending.
Winfree, in an interview with The Daily Signal, also warned that the individual mandate may not be subject to repeal through reconciliation because of the Byrd Rule. In a test of what qualifies as “extraneous matter”—the Byrd Rule includes six definitions—a provision must not be “merely incidental to the non-budgetary components” of a provision.
Because a repeal of the individual mandate would cause a change in behavior, in that individuals would no longer be forced to purchase insurance, it would not pass the “merely incidental” test, Winfree warned.
The Senate committees with jurisdiction over Obamacare have not approved reconciliation proposals. Those plans could differ from what was passed by the three House committees.