GOP budget proposal calls for ACA repeal, Medicare transformation

The Affordable Care Act (ACA) would be repealed, and people 55 or younger would have more options for Medicare coverage when they turn 65 under a federal budget proposal wending its way through the U.S. House of Representatives.

The budget proposal was unveiled April 1 by U.S. Rep. Paul Ryan, chair of the House budget committee and the Republican’s 2012 vice presidential candidate.  

While the proposal may be passed by the Republican-controlled House, political observers say it has no chance of passage in the Democratically-controlled Senate, which probably won’t even consider it. 

The proposal, titled “The Path to Prosperity,” cuts federal spending by $5.1 trillion as part of an effort to balance the federal budget in 10 years. Among other steps for achieving that goal, it would:

• repeal the ACA,

• give people who turn 65 in 2024 and afterwards the choice of enrolling in traditional Medicare or enrolling in a private plan on a newly-created “Medicare Exchange,”

• provide a premium-support payment either to pay for entirely or partially offset the Medicare private plan premium, depending on the plan’s cost,

• eliminate the Medicaid expansions included in the ACA, and

• give states block grants with which to fund the federal portion of Medicaid expenses

Most news media outlets dismissed the budget proposal as little more than a political document. The New York Times, in an editorial, said “This is a document designed solely to be reduced to a few bullet points so House Republicans can have something to show their most antigovernment voters.” The website Politico called it “little more than a political document to serve as an outline of Republican priorities going into the November election.”

The budget committee approved the proposal April 2 on a party-line vote of 22-16, and the full house is expected to vote on it the week of April 7.