Vice President for
Federal Fiscal Policy
Congressional Republicans’ expected vote this week to approve a budget resolution — the first step in their plan to repeal the Affordable Care Act (ACA) — fails the test of sensible policymaking: having the key information available before voting. With this budget resolution, Republicans haven’t provided any details on the ACA replacement that they promise to enact, nor have they begun to show how this major policy change fits with their other tax and spending plans that could ultimately involve trillions of dollars.
Ironically, Congress created budget resolutions (through the 1974 Congressional Budget Act) specifically to have a vehicle to put all of its policy proposals with budgetary effects in one place and determine their combined impact.
The GOP’s budget resolution, however, doesn’t do that. It’s basically an empty shell, designed to give Congress the authority to generate a “reconciliation bill” — a special budget bill that can’t be filibustered in the Senate — that would repeal the ACA. Though the resolution says it “sets forth the appropriate budgetary levels for fiscal years 2018 to 2026,” its figures largely reflect current law, not Republican proposals to repeal the ACA or the other big policy changes they are championing.
Republicans themselves should want to know how their policies will add up. While the budget resolution that Congress will consider this week provides no information, even their previous budgets don’t provide much of a guide. For instance, previous Republican budget resolutions called for repealing the ACA, but they counted the spending savings from ending its coverage expansions while failing to account for the revenue loss from ending its tax provisions. If the Republicans’ forthcoming ACA repeal bill follows last year’s version, it would lose roughly $1 trillion in revenue over ten years, raising the question of whether Republicans plan to offset this lost revenue and, if so, how?
Nor have their previous budgets shown how much Republicans plan to spend to replace the ACA’s coverage expansions to protect the 30 million Americans who could become uninsured if the ACA is repealed — or how they’d offset the cost. Moreover, previous Republican budgets proposed deeply cutting Medicaid (as well as converting it to a block grant or imposing a per capita cap), which would place at risk the health coverage for tens of millions of additional low-income people. They have used those savings to claim their budgets would reach balance within a decade, while ignoring the effects on health care coverage (and their own claim that they would replace the coverage the ACA has provided).
House Republicans have released somewhat more information about their tax reform plan. But those laws would cause revenue losses of $3.1 trillion over ten years, according to Tax Policy Center estimates. And President-elect Trump has talked about spending more on defense and infrastructure.
These various proposals could force very big cuts in programs that aren’t Republican priorities, especially if Republicans maintain their goal of balancing the budget without raising any new revenue.
While a budget resolution won’t provide all the details of tax and spending bills that flow from it, it’s still an important roadmap for legislating. And even if Republicans outline their budget priorities in a second budget resolution they’re expected to unveil this spring, it would come well after critical votes to repeal the ACA. Congress needs to know how the different Republican policy pieces fit together before it takes this first step. Without a real budget, Congress is legislating in the dark.
Senate Budget Committee Chairman Mike Enzi has called for “fixing American’s broken budget process,” asserting that the process laid out in the 1974 law has “grown more dysfunctional and antiquated.” But the new budget resolution suggests the real problem isn’t the process itself but how the Republicans are now twisting and distorting it.