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Republicans to Joint Select Committee: Repeal PPACA, Scrutinize Entitlement Programs

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A group of Senate Finance Committee Republican members submitted recommendations to the Joint Select Committee on Deficit Reduction, outlining seven guiding principles and six proposals aimed at tax reform, including, unsurprisingly, repeal of the Patient Protection and Affordable Care Act (PPACA) and its tax increases.

Finance Committee Ranking Member Orrin Hatch, R-Utah, has been very vocal in his antipathy toward PPACA.

Hatch was joined by Senators Chuck Grassley, R-Iowa, Mike Crapo, R-Idaho, Pat Roberts, R-Kansas, Mike Enzi, R-Wyo., John Cornyn, R-Texas, John Thune, R-S.D., Tom Coburn, R-Okla. and Richard Burr, R-N.C.In a letter to Joint Committee Co-Chairs Senator Patty Murray, D-Wash and Rep. Jeb Hensarling, R-Texas, the senators wrote, “As members of the Senate’s Committee on Finance, we are submitting our recommendations on tax, entitlement programs, and trade policy that make meaningful contributions to deficit reduction.” 

Under the Budget Control Act, congressional committees could submit recommendations to the Joint Committee by today. 

On Medicare, the Senators recommended reviewing a multitude programs under Medicare, parts A through D, including reevaluating the eligibility age.

Other recommendations include evaluating the impact of supplemental coverage, establishing a uniform deductible covering Medicare Part A and Medicare Part B services, strengthening efforts against fraud, waste and abuse, reducing geographic variations in health spending, realigning provider payments; and evaluating existing cost-sharing structures for post-acute services.

For Medicare Part B, the Senators recommended the evaluation of the Medicare Part B cost-sharing threshold to ensure the long-term health of the Supplementary Medical Insurance (SMI) Trust Fund.

For Medicare Part C, the Senators recommended examining approaches that competitively set reimbursement to plans and simultaneously preserve access in rural areas; and promoting reforms that encourage innovative plan designs to meet beneficiary needs.    

For Medicare Part D, the Senators recommended a reevaluation and examination of the current Part D cost-sharing thresholds.

The Medicaid program needs to be modernized, too, the senators said, to employ the state-empowered welfare reform model of the 1990s with states and governors leading the way through even revamping eligibility.

The group recommended collapsing the Social Services Block Grant, the Child Care and Development Fund and the Temporary Assistance for Needy Families into one funding stream for states, the Social Services Fund.

For Social Security, the senators listed a series of principles reforms should follow, including urging that the disability insurance component of the Social Security system – with a trust fund that will be exhausted as early as 2016 – must be a part of any overall Social Security reform effort.