Finally, the question of how Republicans will use budget reconciliation is being answered.
Both the House Energy and Commerce and Ways and Means committees will mark up reconciliation legislation this week, with the end goal of eventually putting bills from all five relevant House and Senate committees into a package that can pass in the upper chamber with only 51 votes—and then head straight for Obama’s veto pen.
The Energy and Commerce bill contains a provision defunding Planned Parenthood for one year, redirecting the $230 million in savings to community-health centers. It also repeals the Affordable Care Act’s Prevention and Public Health fund, which saves about $12 billion, according to senior committee staff.
The Ways and Means bill eliminates major pieces of the ACA, rendering it essentially moot. Included are repeals of all of Republicans’ most-hated pieces of the law: the individual mandate, the employer mandate, the medical-device tax, the “Cadillac” tax on high-cost health care plans, and the Independent Payment Advisory Board.
A third House committee, Education and Workforce, will also contribute a piece to the reconciliation package. The two Senate committees with jurisdiction are Finance and Health, Education, Labor and Pensions.
“We … will take steps to protect taxpayer dollars from programs and organizations that do not live up to the standards and priorities of the American people,” said Energy and Commerce Chairman Fred Upton in a statement. “As this committee continues to investigate Planned Parenthood and its affiliates, the flow of taxpayer dollars should end.”
Budget rules allow for a reconciliation bill to contain multiple provisions in different areas, as long as they all fall within the jurisdiction of the five relevant committees.
Several steps of the reconciliation process remain, but it seems that as the dust is settling, the future is becoming more clear: Congress will pass a continuing resolution that funds both the government and Planned Parenthood until December, and then at some point it will pass a bill that both repeals major pieces of the Affordable Care Act and defunds Planned Parenthood. Obama, of course, will veto the bill.
Specifics aside, the procedural tool will be used as a way for congressional Republicans to gain a small, if largely symbolic, victory after a long summer of falling on the losing side of intense partisan debates in the health care arena. If all goes according to plan, it will allow the GOP to point to concrete examples of what it has done as the majority party in both chambers of Congress, but also of what could become law under a new president with different values in 2017.
Reconciliation first became a subject of fierce debate as Congress waited for the Supreme Court to decide King v. Burwell, a case challenging subsidies given under the ACA on federal exchanges. Had the Court ruled against the Obama administration, it would have blown a hole in the law and threatened the health coverage of thousands. Several plans to temporarily extend subsidies while repealing big pieces of the law began emerging in the Senate, introduced by Republicans but dismissed as nonstarters by Democrats. Reconciliation came up as a way to put the “King fixes” on the president’s desk without the assistance of Democrats.
But the Supreme Court sided with the administration and the law was left intact, leaving Republicans with the sudden dilemma of what came next—if anything—in their relentless quest against Obamacare. The answer quickly emerged: The GOP, for the most part, punted to 2017 and the possibility of a Republican president who will sign a repeal bill.
But before that, they said, reconciliation could be used to put an Obamacare repeal in front of the president, as congressional Republicans had promised the voters who sent them to Washington they would. While it seemed widely understood that this was the most likely use of the budget tool, however, leadership repeatedly emphasized that there was no rush to use it.
“It’s still open. No final decision has been made,” Sen. John Barrasso told reporters in early July. “Had the Supreme Court ruled the other way, there would have been an immediacy to have to use reconciliation with regard to a King decision, but since the decision went the other way, that immediacy isn’t there. So reconciliation is still a useful tool, and I expect it to be used.”
And then came a new controversy: federal funding of Planned Parenthood. Less than a month after the Affordable Care Act survived its second Supreme Court challenge, a series of sting videos targeting the women’s health care organization stirred another bitterly partisan fight on Capitol Hill. The videos allegedly show Planned Parenthood selling fetal tissue, which is illegal. The organization denies the allegations, saying that it only donates the tissue for medical research and is reimbursed for overhead costs. Several congressional investigations are underway.
But simply investigating the organization and its activities is not enough for most Republicans, who want to see the organization lose its federal funding. A group of right-wing conservatives in the House, joined by presidential candidate Sen. Ted Cruz, began calling for a defund provision to be included in a must-pass spending bill, even if that led to a government shutdown.
GOP leadership, on the other hand, learned from the shutdown in 2013, in which Cruz played a leading role as well. Not only was the party unsuccessful in its attack against the Affordable Care Act, but it also shouldered the blame for a 16-day shutdown that enraged many Americans. Both House and Senate leaders have insisted the government will not shut down again this year.
To placate conservatives, however, leadership said a stripping of Planned Parenthood funding should instead be put in a reconciliation bill. House Speaker John Boehner discussed this alternative with House leadership in a meeting just a day before he announced his resignation last week. He resigned amid pressure from the House Freedom Caucus, whose members were threatening to try to oust him as speaker if the spending bill process didn’t go their way. His resignation removes that threat, clearing the way for a short-term, clean spending bill to pass through the House and thus averting a shutdown.