John Shinkle/POLITICO GOP aims to sink Obamacare with reconciliation But first they have to strike a difficult deal on an overall budget

Senate Republicans want to use a powerful budget maneuver known as reconciliation to go after President Barack Obama’s health care law — particularly if the Supreme Court strikes down key provisions of Obamacare this June.

Using the fast-tracking procedure offers some advantage for Republicans, largely because a reconciliation package can’t be filibustered.


But it’s not going to be easy. First, House and Senate Republicans need to agree on a budget resolution, which could be difficult with fiscal conservatives calling for spending cuts but defense hawks looking for more money for the Pentagon. And, of course, President Barack Obama could veto any reconciliation bill that reaches his desk.

Still, Republicans are hoping the procedural maneuver will get them closer, at least symbolically, to gutting the president’s signature health care law.

The plans were included in a budget blueprint rolled out Wednesday by the Senate Budget Committee — a governing document that calls for balancing the budget within a decade, extracting hundreds of billions in savings from Medicare and turning over more responsibility to the states to run Medicaid, reducing costs even further.

“Make no mistake, our fiscal outlook is grim and has been ignored for far too long,” said the budget panel’s chairman, Sen. Mike Enzi (R-Wyo.) said as he unveiled the document. “But we have a profound moral responsibility to help hardworking taxpayers see the true picture of our country’s finances.”

While Senate and House Republicans share a common goal of substantially trimming the deficit in future years, they’ve got some near term differences to work out, particularly on defense spending.

Both chambers want to keep the caps on defense spending that were outlined under a 2011 deficit-reduction law. But the House relies heavily on a war contingency fund to boost defense spending to the tune of $94 billion — an amount that goes too far for Senate Republicans, who have already said using the so-called Overseas Contingency Operations fund is a “gimmick.”

The Senate wants to match Obama’s request on OCO funds for fiscal 2016 at $58 billion — far lower than the House. And Senate budget writers included a so-called deficit-neutral reserve fund that could be used for additional defense spending, though details of how that fund would work have yet to be worked out.

But some Senate Republicans were skeptical of Enzi’s blueprint, arguing it doesn’t go far enough to raise Pentagon spending. Senate Armed Services Committee Chairman John McCain (R-Ariz.) said on Wednesday that he would oppose it as written — because it stayed under the military spending caps outlined in the Budget Control Act — and said he wants to boost defense further, even if that means relying on the Overseas Contingency Operations fund.

Still, Republicans were optimistic about the prospects of striking an agreement with their counterparts in the House.

“I don’t see that as a challenge,” said Sen. Rob Portman (R-Ohio), a member of the Budget Committee. “I think if we end up getting a budget passed here, and pass a budget in the House, we should not have a difficulty in finding common ground in conference.“

Though budgets are largely partisan documents without the force of law, a budget agreement is important because it paves the way for a reconciliation measure, which can’t be filibustered in the Senate. That means a bill targeting Obamacare can reach the president’s desk without support from Democrats.

On reconciliation, the Senate GOP budget calls on two key committees that oversee Obamacare — Senate Finance and Senate Health, Education, Labor and Pensions — to each find at least $1 billion in deficit-reduction savings from the health care law by July 31.

That number was set intentionally low, according to the committee, to give senators some flexibility on their health-care response depending on how the Supreme Court rules in King vs. Burwell, which targets the subsidies under Obamacare given to lower-income individuals so they can buy coverage on state health-care exchanges.

If the court rules against the Obama administration and the subsidies are no longer allowed, Congress will be hard-pressed to come up with a quick response. A decision is expected in late June.

Enzi’s counterpart in the House, Rep. Tom Price (R-Ga.), said on Tuesday that House Republicans will use reconciliation to repeal Obamacare provisions “in their entirety” — in an effort to force Obama to finally veto a rollback of his signature domestic policy achievement.

Overall, the Senate GOP budget envisions about $430 billion of savings from Medicare over a decade, although it doesn’t use the so-called “premium support” approach used by the House. That method, popularized by former House Budget Committee Chairman Paul Ryan (R-Wis.), would allow future seniors to choose between private health care plans with government subsidies or stay on Medicare. Democrats have said Ryan’s plan would end Medicare “as we know it” and used it against Republicans on the campaign trail.

Instead, Senate Republicans call on individual committees responsible for Medicare to work to find those savings.

Senate Republicans also want to change Medicaid so it’s administered more like the Children’s Health Insurance Program, which they say gives the states more flexibility to administer health care for lower-income people. The GOP budget estimates savings from Medicaid to be about $400 billion over 10 years. Meanwhile, Senate Republicans see roughly $600 billion in savings over a decade from overhauling welfare programs such as food stamps.

“It’s a budget that controls spending, reduces the deficit, and improves programs like Medicaid,” Senate Majority Leader Mitch McConnell (R-Ky.) said. “It’s a budget that will support economic growth and more opportunity for hardworking families, while protecting our most vulnerable citizens. And it’s a budget that would allow us to repeal and replace a program that hurts the middle class: Obamacare.”

Predictably, Democrats immediately criticized the blueprint, with Sen. Bernie Sanders (I-Vt.) saying that under the budget, “the rich get much richer, and the Republicans think they need more help.”

“The middle class and working families of this country become poorer, and the Republicans think we need to cut programs they desperately need,” Sanders, the top Democrat on the Budget Committee, said Wednesday. “Frankly, those may be the priorities of some of my Republican colleagues in this room, but I do not believe that these are the priorities of the American people.”