House Budget Committee Chairman Paul Ryan (R-Wis.) has released the House GOP fiscal year 2015 budget, which includes $5.1 trillion in spending cuts over the next decade.
Roughly $2.9 trillion of those cuts involve healthcare. The budget would also repeal the Patient Protection and Affordable Care Act. "The healthcare law has been a costly mistake, so this plan calls for a full replacement," Mr. Ryan writes in the budget blueprint.
His budget would make significant changes to Medicare, reducing program spending by $129 billion over the next 10 years. Starting in 2012, it would convert Medicare to a premium support program, under which beneficiaries would receive funds from the government with which they could purchase either traditional Medicare coverage or private health plans.
Additionally, the proposal would expand means-testing for high-income seniors enrolled in Medicare Parts B and D and reform medical liability insurance by advancing "commonsense curbs on abusive and frivolous lawsuits." Furthermore, the budget creates a budget-neutral reserve fund for a long-term solution to Medicare's sustainable growth rate formula. Every year since 2003, Congress has been passing short-term legislative fixes to shield physicians from steep pay cuts under the SGR. The latest patch — signed into law yesterday — delays a double-digit reimbursement reduction through the end of March 2015.
Mr. Ryan's budget also advises fundamentally reforming the Medicaid program. Although the "exact contours" of Medicaid reform would be determined by committees in each jurisdiction, the Republican budget would give states more flexibility in how they use federal Medicaid funds and would eliminate federal program requirements and enrollment criteria.
The House Budget Committee is scheduled to mark up (debate, amend and/or rewrite) the legislation today.
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