House Republicans Look To Cut $20 Billion Out Of Health Reform Implementation

Congressman-elect Tim Scott (R-SC)

The incoming House Republican majority has offered some new specifics over which parts of the Affordable Care Act they want to defund, telling CNN’s Senior Congressional Correspondent Dana Bash that are they considering blocking some $20 billion to implement the new law. That’s the idea from incoming GOP freshman Tim Scott (R-SC):

Scott of South Carolina, who sits on the House Republicans’ 22-member transition team, said he has already identified tens of billions to cut.

For example, he said there is some $20 billion that’s set to implement the health care bill that they can withhold. He also talked about cutting $7 billion from the federal budget by reducing federal travel by 50 percent.

“There are a lot of things we can look at,” said Scott. “The key is to have a panoramic view of what we’re walking into and make decisions.”

I’ve called the House Majority Transition Office to get more details on where they’re getting this $20 billion figure, since it seems a bit excessive. They haven’t gotten back to me yet, but a search of Congressional Budget Office estimates suggests that they’ve added a few large numbers together. Here is a May estimate from the CBO:

Costs to the Internal Revenue Service (IRS) of implementing the eligibility determination, documentation, and verification processes for premium and cost-sharing credits. CBO expects that those costs will probably total between $5 billion and $10 billion over 10 years.

Costs to HHS, especially the Centers for Medicare and Medicaid Services, and the Office of Personnel Management for implementing the changes in Medicare, Medicaid, and the Children’s Health Insurance Program, as well as certain reforms to the private insurance market. CBO expects that those costs will probably total at least $5 billion to $10 billion over 10 years.

Republicans may strip the funding out in the House — although doing so carries its own set of political risks since they would be jeopardizing some very popular reforms — only to see it stall in the Senate and result in a stalemate that could lead to some very serious implications.

The American Enterprise Institute’s Norm Ornstein describes this scenario: A Republican budget that greatly limits implementation funds “won’t move through Senate, so goes to conference where Democrats won’t yield.” “More than likely Democrats in the Senate would put through a continuing resolution until it could be resolved. Then you could see Republicans in the House, driven by new members saying they won’t cave, not sign off on the CR. That’s where you could get a shutdown of HHS,” he said.