Is Health Care Passage Assumed In The Budget?


The federal budget doesn’t just have items that will be included in appropriations bills. It seeks to set out budgetary assumptions based on the expectation of passage of certain federal policies. For example, ending the privatization of the student loan system, which was passed last year by the House and may still come up in the Senate, is assumed in the budget.

Another area where this comes into play is health care reform. If the package that has passed both chambers was assumed to pass, it would be included in the budget. So, is it? David Herszenhorn thinks so.

President Obama says he has not given up on major health care legislation, and his new budget backs him up. The $3.8 trillion budget released by the White House on Monday includes $150 billion in deficit reduction over 10 years on the presumption that a health care bill will be adopted […]

In a statement Monday night, Representative Anthony Weiner, Democrat of New York, said: “Hidden clue in budget documents — health care reform is alive.”

However, Janet Adamy notices some back-up plan in case reform withers away.

But in other ways, the budget suggests the White House did not assume fast passage of the health bill, which is now stalled in Congress after Democrats lost their super-majority with last month’s Senate election in Massachusetts. The blueprint includes several specific provisions originally contained in one of the versions passed by Congress.

The biggest is a $25.5 billion increase in Medicaid funding to appease nervous governors who had already factored that money into their budgets. There’s also $290 million in funding for community health centers. They cater to low-income areas and were slated to receive a big spending boost under the health bills.

Three little-noticed components of earlier health bill versions also are tucked inside the budget. One is a $6.6 billion savings from closing a loophole that allows paper manufacturers to claim cellulosic biofuel tax credits. There’s an $84 million package of new tax compliance provisions for corporations. And then there’s $23 million to codify an “economic substance doctrine,” which prevents companies from engaging in sham transactions solely to reduce their tax liability.

If the Congress passes the budget with some of these savings, like the black liquor issue (the cellulosic biofuel tax credits mentioned above), then those monies are not able to be used in the health care bill. The excuse is that they don’t know exactly which revenue items and savings will show up in the bill, so they’re covering their bases. But clearly, they’re setting up for a Plan B at the same time, at least to save these particular budget reducers.

Clearly, the White House and Democrats in Congress are in no rush to come up with an endgame for the legislation. Perhaps this is to increase popularity among the public for Democrats in general, focusing on jobs and financial regulations. In the meantime, leadership is at least talking about how to manage the strategy.

However, some fear the opportunity for endless obstruction in the “vote-a-rama” at the end of any reconciliation process, where Republicans could offer unlimited amendments (ironically, this would be a version of the “live filibuster” that many on the left have been clamoring for). And the Virginia State Senate’s passage of a bill blocking the individual mandate, while unlikely to stand up in court, could dampen the desire for lawmakers to want to press forward. Ezra, in a reversal, offers a second path:

There continues to be a part of me that thinks Democrats should just send Medicare buy-in, a large Medicaid expansion, tax credits and a tax on the rich through the reconciliation process. The problem with that plan is that the interest groups would howl and fret, which means Democrats won’t do it. But as things stand, Democrats are stuck defending a policy compromise that no one on the other side has agreed to, and too few on their side are excited about.

FDL News will have more on this later today.

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