Will Republicans Be Able To Defund Health Care Reform?

Over at the Hill’s Blog Briefing Room, Jordan Fabian is reporting that Sen. John McCain (R-AZ), one of the earliest and most vocal advocates of repealing the health care reform law, is now backing a new plan “that he says would allow the Republicans to avoid a presidential veto while negating the effects of a new healthcare law.” “The 2008 GOP presidential nominee backed a plan that would strip funding from the healthcare law, which he says would not take an override to a veto to accomplish”:

“When I say repeal, people say you’re not going to be able to do it,” he said on KQTH FM Radio. “I am confident we will get majorities in both houses in the fall. And that means the power of the purse…If we cut off the money, it doesn’t take an override to a veto.”

As Fabian notes, “Eliminating funds for the health law would likely be done through the appropriations process in Congress, but it is unclear how Republicans would accomplish their goal by sidestepping a veto. Under the constitution, the president has the right to veto any bill that is passed by Congress.” Indeed, it’s also unclear how much damage the Republicans could actually do, since most of the reform legislation is funded through mandatory spending, which is harder for Congress to control than discretionary spending.

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.