House Uses Procedural Move to Approve Rep. Ryan's Budget Proposal

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On Tuesday, The House in a procedural move on Tuesday approved Budget Committee Chair Paul Ryan's (R-Wis.) fiscal year 2013 budget proposal, the Los Angeles Times reports.

The House voted 228-184, with no Democrats voting in favor, to deem the budget passed by attaching it to an unrelated bill setting the rules for debate on a sports hunting bill (Mascaro, Los Angeles Times, 4/17).

Ryan's budget plan, which passed the House in March, would transform Medicare from a fee-for-service program to one in which beneficiaries could either purchase coverage on the private market or maintain traditional Medicare coverage. The proposal also would reduce Medicaid spending and convert the program to a block-grant system, in which states would receive a fixed amount (California Healthline, 4/3).

Republicans said that without action or an agreement with the Democrat-controlled Senate, the move was necessary to push forward with a plan for FY 2013.

House Minority Leader Nancy Pelosi (D) called the vote a "stunt" (Los Angeles Times, 4/17).

Ryan Defends Budget Plan

At a hearing on Tuesday, Ryan countered criticism of his proposal, saying its Medicaid overhaul would aid low-income residents similar to the way President Clinton's welfare reforms did in the 1990s, The Hill's "Healthwatch" reports (Pecquet [1], "Healthwatch," The Hill, 4/17).

Ryan said that his budget "treats all Americans with respect and dignity" and that it would strengthen the social safety net while weaning people from government dependency, according to CQ HealthBeat (Reichard, CQ HealthBeat, 4/17).

House Ways and Means Committee Proposes Requiring Repayment of Subsidy Overpayments

The House Ways and Means Committee on Tuesday said it will mark up legislation on Wednesday to save $43.9 billion over 10 years by requiring U.S. residents to repay overpayments on subsidies they receive to help purchase health coverage under the federal health reform law, "Healthwatch" reports.

Under Ryan's budget proposal, the committee is charged with identifying policies to reduce the deficit by $53 billion between 2013 and 2022 (Pecquet [2], "Healthwatch," The Hill, 4/17).

Sen. Conrad To Introduce Bipartisan Budget Plan

On Tuesday, Senate Budget Committee Chair Kent Conrad (D-N.D.) announced that instead of introducing a Democratic budget plan in his committee this week, he will introduce a version of a bipartisan budget plan developed in 2010 by former Sen. Alan Simpson (R-Wyo.) and former Democratic White House Chief of Staff Erskine Bowles, the Washington Post's "2chambers" reports (Helderman, "2chambers," Washington Post, 4/17).

Conrad also said he will not ask senators to vote on the proposal, noting that he instead wants to spend more time developing bipartisan consensus on the plan (Friedman, National Journal, 4/17).

The Simpson-Bowles plan includes recommendations to institute a new formula to reimburse Medicare physicians by replacing the sustainable growth rate formula; establish and enforce a federal budget for Medicare and Medicaid; and adopt comprehensive malpractice reform, among other health care proposals (California Healthline, 11/2/11).

The announcement surprised many members of both parties, who were expecting Conrad to introduce a Democratic budget (Weisman, New York Times, 4/17).

Michael Samms
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