The bill received support from 179 Republicans and 81 Democrats in the House, including House Minority Whip Steny Hoyer (D-Md.) and Rep. Chris Van Hollen (D-Md.), the ranking member on the House Budget Committee. Former House speaker and current Minority Leader Nancy Pelosi (D-Calif.) did not vote in favor of the resolution. She said in a news conference on the day of the vote that she felt “no ownership” to the bill as House Democrats were not involved in the final agreement. After the House's vote, the Senate passed the bill in a vote of 81-19 but rejected two Republican resolutions: one that would have blocked funding for last year's Patient Protection and Affordable Care Act, and another to prohibit funding for Planned Parenthood. Those separate Senate votes were included in the final agreement by the House, Senate and White House. Healthcare experts said last week that resolving this current spending debate just sets the stage for the looming budget battle for next year, which includes suggestions from both political parties on how to reduce the nation's massive debt and deal with the country's healthcare entitlement programs.
For healthcare, the hard-fought continuing resolution for the remainder of fiscal 2011 not only reduced funding for specific programs, but it also targeted certain sections of last year's healthcare law.
“Now these are real cuts that signal to job creators that we're serious about stopping Washington's spending binge,” Boehner said in a news conference hours before the House passed the bill in a 260-167 vote. “But that's not all. The bill eliminates one of Obamacare's programs; it cuts another one in half; it eliminates funding for four of the president's czars, and terminates dozens of federal programs,” he continued. “It means Washington will spend $78.5 billion less than what the president wanted to spend for this year.”
The first Affordable Care Act provision Boehner referred to is the free-choice voucher program. That provision said that if the share of income a worker would have to pay for single coverage from his or her employer exceeds 8% but is less than or equal to 9.8%, the employer would have to offer that worker a voucher that could be then used to purchase coverage in the health insurance exchanges, according to a joint summary from the bipartisan Congressional Budget Office and Joint Committee on Taxation.
Dr. Kavita Patel, a fellow and managing director of the Engelberg Center for Health Care Reform at the liberal Brookings Institution, said from a policy standpoint, people began to realize the voucher program wasn't such a great idea after the bill was signed into law.
“I think the insurance industry pointed out there was a tension with the free-choice voucher and could be a big problem with the mid- and large-group markets,” Patel said.
This section of the law “was insanely complicated,” according to Edmund Haislmaier, a senior research fellow in health policy studies at the Heritage Foundation, a conservative think tank on Capitol Hill. Although the voucher provision doesn't have federal funding attached to it, its removal from the healthcare reform law is still significant, Haislmaier said.
The other Affordable Care Act provision that was weakened in the continuing resolution is the Consumer Operated and Oriented Plan, which is intended to foster the creation of qualified not-for-profit health insurance issuers that would offer health plans in the individual and small-group markets. The law also required the comptroller general to establish a 15-member advisory board—which happened last June—to make recommendations to the HHS secretary on how grants and loans are awarded. In the continuing resolution, lawmakers agreed to rescind $2.2 billion, which reflects the initial funding for this $6 billion program.
“There was a need to find different places where there were billions of dollars, if eliminated, that would not eliminate an entire program,” Patel said. “It's the startup funds. It really just means it's delayed a year,” she said, noting that this funding agreement only lasts through late September. Looking ahead, Patel said she thinks it will be difficult for Democrats and Republicans—both of whom have a lot at stake during an election year—to reach a compromise on funding for fiscal 2012. “I have a feeling we're going to get even more into a (government) shutdown next year,” Patel said. “I don't see any sort of agreement.”