"Can Republicans Simply Defund Health Reform in November?"
Earlier this year, several prominent Republicans including House Minority Leader John Boehner (R-OH) and Newt Gingrich suggested that they could repeal the new health care reform law by defunding it if they regain Congressional majorities in November. “I can’t imagine a Republican Congress is going to give this President the money to begin this process,” Boehner told Fox News in March. “It’s perfectly legitimate for the Congress to say, I can’t as a matter of good faith to the very people who elected me, give you money to do something they elected me not to do,” Gingrich added in April.
But this afternoon, during an event organized by the Alliance for Health Reform, Gail Wilensky, administrator of CMS under George H. W. Bush, explained why this strategy is unlikely to stop reform:
WILENSKY: It has been very difficult historically to do this type of a starving unless you have a very large majority behind you…So you could technically see this as a way to go after all those thing that are not mandatory funding. But a lot of the activity in this early period is, I think not at risk. So I think the real question is going to be what happens in November? What happens in 2012? And whether or not there is significant change in the mood of the country about where we are with regard to this amount of increased spending and the benefits that are associated or not. I would find it that, there are some technical possibilities for those provisions. But I would find it surprising if that had a big effect.
Indeed, mandatory spending, such as Medicare and Medicaid, continues from year to year unless Congress passes new legislation to reduce it; discretionary spending, which covers most of the day-to-day operations of federal agencies, is appropriated every year in annual appropriations bills. It’s far easier for Congress to adjust an appropriations mark than muster the political support to pass new legislation to defund the new Medicaid expansion or affordability credits to middle class Americans.
The CBO has identified “at least $50 billion in specified and estimated authorizations of discretionary spending that might be involved in implementing that legislation,” with most the costs associated with implementing the new policies established under the legislation and “a variety of grant and other programs.” You can read the entire breakdown here, but I suspect that the GOP’s effort to defund the bill will be just as politically popular as their short lived campaign to repeal the entire legislation, including protections against pre-existing condition exclusions. McCain has had to backtrack from that and I wouldn’t be surprised if he’ll reverse himself here as well.