The House-passed amendment takes aim at the Department of Health and Human Services. House pulls plug on health law funds

The House voted Friday to block funding for the health care law in several ways – starting the countdown to the defunding clash with Senate Democrats and President Barack Obama.

As expected, lawmakers approved Rep. Denny Rehberg’s amendment to the continuing resolution, which bars all payments to “any employee, officer, contractor, or grantee of any department or agency” to implement the law.


The Montana Republican’s amendment is aimed at the Department of Health and Human Services and the Labor Department.

But they also gave unexpected victories to Steve King of Iowa, approving broader measures to deny any implementation funds in the continuing resolution and block salaries to enforce the entire law.

And another measure by Jo Ann Emerson of Missouri to block funding for the Internal Revenue Service to enforce the individual mandate – the wildly unpopular requirement for everyone to get health coverage starting in 2014 — was also approved.

Later, the House added two more amendments that target narrow pieces of the law. One, by Cory Gardner of Colorado, would stop payments for federal work on health insurance exchanges, while another measure by Tom Price of Georgia would cut off funds for a new rule about how much health insurers have to spend on patient care.

None of the measures completely “defund” the health care law, because large sums of money are out of the reach of the spending bill. King lost an earlier bid, as expected, to cut off the roughly $105 billion that’s automatically appropriated under the law. It was struck down on a point of order because it was considered legislating on an appropriations bill.

But taken together, they could add one more element of tension to the growing prospect of a government shutdown. That’s becoming a more realistic possibility if Obama, House Republicans and Senate Democrats can’t find common ground on the bill to fund the government for the rest of the fiscal year – and especially if they can’t agree on spending levels for a short-term extension to buy them some time.

In an interview with POLITICO after the vote, King described the approach as “driving a spike in here and a spike in there.” He said Rehberg found a crucial opening in the limits that make it hard to defund the entire law, “and then we were able to open up a bigger wedge and then another bigger wedge.”

The amendments won’t become law, as they’re written now, because they won’t get through the Democratic Senate. But they’ll be powerful bargaining chips when the House negotiates the final spending bill with the Senate — and probably with the administration, since Obama would have to sign it into law.

The vote on Rehberg’s amendment was 239-187. A related amendment by Cathy McMorris Rodgers of Washington, which tried to accomplish the same thing at the IRS, was struck down on a budget point of order.

King won his bid to block implementation funds in the spending bill on a 241-187 vote, and his salary cutoff measure was approved 237-191. And Emerson got her individual mandate defunding amendment into the bill on a 246-182 vote.

Any one approach to defunding has its limits, but House Republicans may be able to their leverage by piling on several approaches in the same bill.

For example, appropriations experts say cutting off salaries by itself wouldn’t stop the law, because the administration probably could find ways around the ban – like moving people around between the White House and other agencies. But it would be disruptive to the implementation efforts – if it ever became law.

“It forces the executive branch to scramble,” said Jim Dyer, a former House Republican appropriations aide who now runs the appropriations practice at Clark and Weinstock. “If I’m a creative little bugger, I’d probably find ways to circumvent it. But I would not circumvent it without a lot of disruption.”

Rehberg, the chairman of the Labor-HHS appropriations subcommittee, told POLITICO after the vote that his amendment still won’t stop all of the law’s mandatory spending, which the appropriators can’t touch.

But he said it could force HHS to create a “firewall” in its implementation work, because the agency’s employees would have to separate their work on mandatory spending programs – which could continue – and their work on discretionary programs, which would have to stop.

Supporters of the health care law say they’re not worried that those restrictions would ever actually happen, though – because Obama and the Senate would never allow it.

“It’s not going to come to pass,” said Ron Pollack, executive director of the health care advocacy group Families USA. “I cannot believe for a millisecond that the president and the Senate would allow this sideshow to undermine the law of the land.”

King, however, said the wide margin of the House votes will give him and the law’s other opponents a strong hand. “It’s not like it was a wobbly amendment,” he said. “It was a resounding message.”

Republicans used Friday’s debate to argue that the law may be unconstitutional and shouldn’t go forward, especially while all the legal challenges are still moving through the courts. Democrats cited all the benefits people would lose if the law is blocked, like coverage for pre-existing conditions and prescription drug coverage for seniors.

Republican Phil Gingrey of Georgia set the tone for the debate on the GOP side when he called the health care law “possibly the worst piece of legislation passed in the history of this Congress.”

And Democratic leader Nancy Pelosi of California, who was largely responsible for pushing the final legislation through the House, did the same for her party when she talked about families that would lose important new protections – like a mother of twins who had cancer. The twins had pre-existing conditions because of that struggle but now have coverage, she said, because of the law.

“The American people are desperate for jobs,” Pelosi said, and Republicans are trying to “change the subject.”

Emerson said the individual mandate should be defunded because with all of the constitutional questions that have been raised in the lawsuits, it would be “irresponsible” for the IRS “to implement something that we don’t actually know if it’s going to be the law of the land.”

She has said, though, that she wants to find other ways to guarantee coverage for people with pre-existing conditions. Democrats and other supporters of the law say that coverage won’t be affordable without the individual mandate, because insurers won’t be able to draw enough healthy people to cover the costs of sick people.

Democrats insisted that blocking the law would increase the deficit by $230 billion, according to the Congressional Budget Office, because of various spending cuts and savings that CBO believes would offset the costs. Henry Waxman of California, the ranking Democrat on the Energy and Commerce Committee, called it a “step toward repealing the biggest deficit cutter in the last decade.”

Republicans, however, said other experts argue that the law will cost more than CBO predicted. “It’s not true” that blocking the law would increase the deficit, Rehberg said. “Nobody believes it.”

“This is not the way to reform health care,” Rehberg said of the health care law. “It’s a job-killer. It’s going to bust our budget.”

Ethan Rome, executive director of Health Care for America Now, said the Republicans who voted for the defunding measures “put their constituents at the mercy of health insurance companies” and would take away “important cost-saving benefits and consumer protections from America’s families, seniors and small businesses.”

“The Republicans are playing an empty shell game with the health care needs of America’s consumers. Their ‘repeal and replace’ campaign pledge was a sham,” Rome said. “The GOP’s only health care plan is to put the health insurance companies back in charge so they can deny our care and jack up our rates.”