GOP wants to remove barrier to starving health reform

House Republicans will hold hearings next week to help craft legislation that would make it possible to defund healthcare reform, Rep. Joe Pitts (R-Pa.) said Thursday.

The chairman of the Energy and Commerce health subcommittee said he wants to redesignate healthcare reform spending so that it’s discretionary rather than mandatory. He also said the panel intends to take up legislation allowing state to cut their Medicaid rolls and get federal block grants to run the program as they see fit.

“We’re going to move to try to make mandatory spending discretionary,” Pitts told reporters after a hearing on the president’s 2012 budget proposal. “We’d like to make them authorizations.”

The panel will also hold a field hearing in Harrisburg with Pennsylvania Gov. Tom Corbett (R). The hearing, scheduled for the week of March 21, will include state Medicaid officials.

Many Republicans ran for re-election last year on a promise to defund the healthcare reform law, but they’ve been stymied because of the way the law was written. Most of the spending is self-executing mandatory spending paid for by provisions in the law, and are out of reach of the budgeting process.

“The big problem with defunding is we couldn’t get at most of it in the Continuing Resolution,” Rep. Michael Burgess (R-Texas) said. “All of the stuff that’s in (the law) as mandatory spending, we couldn’t touch … that’s all baked in the cake right now and we don’t have access to it.”

Rep. Steve King (R-Iowa) last month tried to add language to Republicans’ stop-gap spending bill that would have cut off all funding for the law, both mandatory and discretionary. He said at the time that his approach could have eliminated an extra $105.5 billion in mandatory spending, but House leaders did not let him offer the amendment because it was considered “legislating on an appropriations bill.”

Instead, House Republicans plan to tackle the law’s mandatory spending through legislation rather than the budget, even if such bills have little hope to passing the Democratic-controlled Senate.

“The chairman is committed that we entertain several bills over the next several weeks that gets at the mandatory spending that’s included in the bill,” Burgess said. 

Pitts said he’s also going to hold hearings on the so-called Maintenance of Effort (MOE), which restricts states from shrinking their Medicaid rolls before the healthcare reform law expands coverage to about 15 million more people starting in 2014. He said he’d then look at ways to offer states block grants to run Medicaid as they see fit, but offered few details.

“The governors have requested flexibility in the way they serve Medicaid patients,” Pitts said. “They maintain that they can provide the service, if they have the flexibility, better and cheaper. So we’re looking to give them that flexibility and change MOE in the law.”

He added that House Republicans would soon be introducing replacement legislation in conjunction with their efforts to repeal the law.

“We only can do this step by step,” Pitts said. “But we will have replacement provisions along the way. Not necessarily in the bills next week, but repeal and replacement will move in a coordinated way.”

The as-yet undetermined timeline will depend in part on what’s happening in other committees, he indicated.

“We’ve got to operate in conjunction with the other hearings that have jurisdiction as well,” Pitts said.

This story was updated at 3:30 p.m.