House Republicans are fighting to stop the federal government from financing state efforts to set up health insurance distribution exchanges.
Members of the House voted 238-183 Tuesday to pass H.R. 1213, a health insurance exchange defunding bill. All Republicans who participated voted for it; it also won the support of 5 of the 188 Democrats who voted.
The bill would repeal a health insurance exchange financing provision included in the Patient Protection and Affordable Care Act of 2010 (PPACA). The provision and related provisions are supposed to help states create state-designed, state-regulated entities that individuals and small employers can use to compare and buy health coverage.
Although the bill sailed through the House, health policy watchers expect it to stall when it reaches the Senate, where the Democrats have a majority.
The bill does not appear to have the votes to pass in the Senate, and the Office of Management and Budget said Monday that President Obama would veto the bill in its present form.
The bill was sponsored by Rep. Fred Upton, R-Mich., chairman of the House Energy and Commerce Committee.
“With our national debt above $14 trillion, we must control spending,” Upton said in a statement about H.R. 1213. “Our committee has spent the early months of this year exposing vast sums of unaccountable spending in the health care law, and this program is a prime example.”
The exchange program funding provision gives the U.S. Department of Health and Human Services (HHS) “an unlimited tap on the federal treasury,” Upton said.
Upton called the provision “another slush fund designed to push the states into doing what
the administration wants using financial leverage.”
Rep. Henry Waxman, D-Calif., the highest ranking Democrat on the committee, said during debate on the bill last month at the committee level that Republicans have claimed to support state-based health reform but voted to take away the money states need to develop their own, unique insurance exchange programs.
Analysts at the Congressional Budget Office estimate H.R. 1213 would save about $14 billion between now and 2021.
California Insurance Commissioner David Jones reacted to news of the passage of H.R. 1213 with a statement criticizing the bill. California has received a $1 million federal exchange planning grant.
“The Affordable Care Act is the law of the land, and the exchange is a critical piece of the new law,” Jones says in the statement. “The Republican effort to defund implementation of health care reform is irresponsible and short-sighted.”
Blocking the exchange program could interfere with the ability of consumers and businesses to use the new PPACA health insurance tax credits, Jones says.
H.R. 1213 is one of three PPACA blocker bills House Republicans plan to move through the House this week.
H.R. 3, would prohibit taxpayer funding for abortions.
H.R. 1214 would cancel mandatory PPACA funding for the construction of school-based health centers and rescind any unobligated balances.
According to the White House, longstanding federal policy already prohibits federal abortion funding, except in the cases of rape or incest or in cases in which the mother’s life is in danger. “H.R. 3 goes well beyond these safeguards by interfering with consumers’ private health care choices,” the OMB says.
The White House opposes H.R. 1214 because, “rather than making refinements to improve the law, H.R. 1214 simply proposes to eliminate funding,” officials say.