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What reconciliation giveth, reconciliation can taketh away.
Since the national health care law passed in March, many have assumed that in order to repeal it, Republicans would have to gain a 60-seat majority in the Senate (on top of winning back the House and the presidency).
But in a phone interview with TAS, Robert Dove, the former Senate parliamentarian, agreed that the major spending provisions of the health care law could be repealed through the reconciliation process with a simple 51-vote majority in the Senate.
“If you eliminated something that was going to spend money, yes, that is in the order under reconciliation,” he said, when asked if the Medicaid expansion and subsidies for the purchase of insurance could be repealed using the parliamentary tactic that Democrats employed to help get ObamaCare across the finish line.
The insurance coverage provisions, which go into full effect in 2014, are projected to cost $921 billion in the first six years alone, according to the Congressional Budget Office. This accounts for the bulk of the spending in the legislation.
However, before conservatives get too excited, Dove cautions that there are “certain caveats.” While the rules of reconciliation would allow Republicans to eliminate spending in the health care law, they could not use the procedure to eliminate the tax increases – even if the overall reconciliation bill still reduced the deficit on a net basis.
“It’s a provision by provision situation,” Dove said. “So every provision in the bill must reduce the deficit.”
The same would be true to any attempt to scale back the Medicare cuts.
“Anything that reduces the deficit is okay,” he said. “And nothing that increases the deficit is okay. It’s just that simple.”
Republicans would not be able to touch the new regulations, get rid of the insurance exchanges, or strike down the mandate through reconciliation, either. But stripping the major insurance coverage provisions could help unravel the rest of the law. Without the subsidies, the insurance exchanges would be narrow in scope and it would be harder to justify forcing lower-income Americans to purchase government-approved insurance policies.
This doesn’t get into the political dynamics, most importantly, whether Republicans would actually be willing, in the face of Democrats’ demagoguery, to use the reconciliation maneuver to eliminate subsidies. But the point is, reconciliation is one option among several others that is available to drastically scale back the health care law.
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