Even defunding might not stop reform law, analysis finds

The budget impact of a permanent ban on future appropriations for the Patient Protection and Affordable Care Act is unclear but it would not necessarily end government implementation of the law, according to a new Congressional Budget Office and Joint Committee on Taxation analysis.

The analysis of Republican defunding plans, requested by Rep. Henry Waxman (D-Calif.), concluded there are too many uncertainties to ascertain the impact of a full repeal of the law on net government spending.

Defunding some provisions of the law would trim the federal deficit and reducing other provisions would increase the federal deficit, according to the analysis. For example, defunding would block implementation of Medicare spending reduction recommendations by the Independent Payment Advisory Board.

“Other provisions of the healthcare laws established some legal rights on the part of providers, states or individuals who could demand certain benefits or payments” even if appropriations were discontinued, according to the May 26 analysis.

Additionally, a cutoff of future appropriations would depend, in part on the ways that HHS officials interpreted the appropriations cutoff.

“It is very difficult for CBO and JCT to determine with any certainty how affected agencies would resolve the conflict between tasks required by the healthcare laws and the lack of funding to administer those requirements,” according to the letter from Douglas Elmendorf, director of the CBO.