Congress Adopts Budget Resolution with Focus on Tax Reform

Andy Bopp

Budget calls for large Medicare/Medicaid cuts

The U.S. House of Representatives narrowly passed a Budget Resolution that mirrors legislation passed by the Senate last week. Passage of this bill allows passage of a tax reform bill in the Senate with a simple majority of 50 votes. The Budget Resolution, if followed by Congress, would increase the federal debt by an estimated $1.5 trillion over 10 years, even though it also calls for $473 billion in Medicare cuts and $1 trillion in Medicaid cuts over the same period. As has been widely reported, Congress and the Administration are now working on a tax reform proposal which would have required 60 votes in the Senate absent passage of this Budget Resolution. Republicans hold a narrow 52-48 seat Senate majority.

It is important to note that passage of budgetary legislation does not necessarily mean that federal spending or programs will automatically be cut. House and Senate Appropriations Committees, which oversee government spending, are free to ignore Budget Resolutions, and both the House and Senate would need to pass additional legislation for the Medicare and Medicaid spending cuts envisioned in the budget to occur. Passage of this Budget Resolution, however, enables the Senate to consider health care reform legislation in 2018 with only a 50 vote majority required for passage. The Senate, as is well known, failed to gain 50 votes to pass major health care reform legislation under the 2017 Budget Resolution that expired in late September.

AOTA has consistently maintained that health care reform legislation should not dramatically reduce Medicaid spending or eliminate Essential Health Benefits mandates that ensure that patients have access to a wide array of essential services, including occupational therapy. In addition, AOTA champions improving access to meaningful coverage and health care services. Moving forward, AOTA would oppose major changes to Medicare that would result in the kinds of cuts proposed in the budget. We will continue to monitor health care reform proposals in Congress and will fully engage if the cuts proposed in the budget were to be considered in the coming year.