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Ways and Means Republicans Take Aim at Health Law

By Alan K. Ota, CQ Roll Call

May 15, 2015 -- House Ways and Means Committee Republicans are laying the groundwork for a veto showdown with President Barack Obama with plans the week of June 1 to mark up proposals to uproot parts of the health care law, including the medical device tax and a panel charged with holding down Medicare costs.

Ways and Means Health Care Subcommittee Chairman Kevin Brady, R-Texas, and other GOP tax writers confirmed in interviews that the full committee has set a target of marking up several health care bills that could be moved to the floor as stand-alone items or combined into larger vehicles, such as the reconciliation measure outlined in the GOP's fiscal 2016 budget blueprint (S Con Res 11).

The lawmakers said the projected early June markup would cover at least two high-profile bipartisan measures: a proposal (HR 160) by Erik Paulsen, R-Minn., to repeal the 2.3 percent excise tax on medical devices and an effort (HR 1190) by Phil Roe, R-Tenn., to eliminate the Independent Payment Advisory Board, or IPAB.

"It's sort of the ones that you would expect," said Brady.

He and other senior House GOP tax writers say they want to be able to move quickly on a reconciliation package or other measures, if necessary, once the Supreme Court rules in a case that takes up health law subsidies in states without their own state-run marketplaces. One option would be to hold stand-alone votes to demonstrate bipartisan support for items that could be included in what's expected to be a contentious reconciliation package—a move that would trigger a showdown with White House.

"I don't think any final decisions on reconciliation will be made until the Supreme Court rules," Brady said, referring to the still emerging strategy for moving the bills to the floor.

"I think we will have a package that we're going to put together," said Kansas Rep. Lynn Jenkins, vice chairman of the Republican Conference.

Paulsen said it was possible that his medical device tax repeal proposal could be moved on its own or in tandem with other measures. "We will move the bills in Ways and Means. And we'll see on the floor. Get a little momentum going," Paulsen said.

Ed Lorenzen, a senior advisor for the Committee for a Responsible Federal Budget, a fiscal watchdog group, said the reconciliation package would be limited to items scored as having an effect either on revenues or direct spending that is not subject to appropriations.

The proposal to scrap the medical device tax, with a projected 10-year cost of about $25 billion, would be eligible for reconciliation. Lorenzen said language eliminating IPAB would also be a candidate because its administrative costs are funded with direct spending. The board, established in the health care overhaul, is charged with making annual cost-cutting recommendations if Medicare spending exceeds a target growth rate. The conditions that trigger the recommendations haven't been met and Obama hasn't appointed any members.

The GOP budget plan calls for the reconciliation package to have more offsets than spending increases or tax hikes, requiring the overall package to reduce the deficit by at least $1 billion.

In the Senate, Health, Education, Labor, and Pensions Chairman Lamar Alexander, R-Tenn., said he planned to hold off moving health care legislation until after the Supreme Court ruling. Finance Chairman Orrin G. Hatch, R-Utah, said he did not plan to wait either for House action or a Supreme Court ruling, but that he wanted to spend more time building consensus for his own proposal (S 149) to repeal the medical device tax.

"Some of those votes on the Democrat side have slipped away. I've got to rebuild them up again...We'll do what we can," Hatch said.

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