House Republicans voted today for a bill that would pummel state budgets, with the most negative impact on low- and middle-income families. HR 1213, which passed 238-183 along party lines, would gut the insurance subsidies passed as part of the Affordable Care Act in 2010 and deny states the funding to set up health insurance exchanges.
The House Energy and Commerce Committee's Democratic ranking member, Henry Waxman, briefed Democrats with a letter yesterday.
The Congressional Budget Office (CBO) budget estimate of H.R. 1213, a bill to repeal the funding for states to establish exchanges from the Affordable Care Act (ACA), shows it cuts $14 billion over 10 years at the expense of low and moderate income Americans being able to access insurance. H.R. 1213 repeals funding in the ACA that will allow states to establish truly transparent and competitive insurance markets – exchanges.
More after the jump.
The CBO letter (Warning: PDF) stated that HR 1213 would reduce deficits by around $14 billion over 10 years, but would do so by keeping 2 million Americans off health insurance exchanges and leaving an additional 500,000 Americans uninsured. Not only would the state exchanges be harmed by a lack of funding, but subsidies would be reduced as well, making insurance less affordable and putting added pressure on businesses to pick up the tab.
As Rep. Pete Stark (D-CA) pointed out in a floor speech:
This legislation is the strangest of the repeal bills they’ve brought up so far. In fact, it is downright comical. If this bill were to be enacted into law, it would actually create a federal takeover of the American health care system – the very thing Republicans campaigned against in the last election cycle!
That’s right. This bill would cause states to lose funding to create health insurance exchanges. However, a key fact that Republicans fail to highlight is that if states don’t establish them, the law requires the federal government to do so. As most states are facing budget crises, a lack of federal funds to develop exchanges would lessen the chance that many states move forward with such plans. Therefore, it would fall to the federal government to take over. That’s what CBO presumes in their analysis as well.
So, we have before us today a bill that I predict all House Republicans will support that would actually mandate a federal takeover of health care and it’s being considered as part of their effort to repeal health reform.
Are you confused? I am too. With this bill before us today, House Republicans have officially “jumped the shark” with their health reform repeal efforts.
The bill, as written by House Republicans, would reduce aid to states and diminish state autonomy, even as Republicans rail against big government. What's more, by reducing the ability of state governments to innovate and find the best solutions for their residents and businesses, consumers would be left with less choice and competition.
House Democrats proposed several amendments to make the bill's intent more transparent. One amendment, proposed by Lynn Woolsey (D-CA), would have added a public insurance option to compete with the private insurance options on the exchanges. Of course, Republicans voted those options down or prohibited them from coming to the floor for a vote.
In the end, it's little more than a political exercise. There is little chance that the Senate will consider HR 1213 and even if the Senate passed HR 1213 (which is unlikely on an up-or-down vote), it's almost assured that President Obama would veto the bill.