Could The ACA Be Repealed?

Rep. Ryan's FY 2014 Budget Proposal Aims To Repeal, Replace ACA

During an interview on "Fox News Sunday," House Budget Committee Chair Paul Ryan (R-Wis.) said his fiscal year 2014 budget proposal -- which he is expected to unveil this week -- would renew the GOP's efforts to repeal and replace the Affordable Care Act, the Washington Post's "The Fix" reports (Sullivan, "The Fix," Washington Post, 3/10).

Although many GOP lawmakers -- including House Speaker John Boehner (R-Ohio) -- have said that the ACA is here to stay, Ryan said Republicans remain opposed to the law and would continue to push for its repeal because they believe the law "will not work" (Bolton, "Blog Briefing Room," The Hill, 3/10).

Ryan dismissed criticism that House Republicans have little hope of dismantling the law, saying Republicans "believe it should" be repealed (Nelson, "Washington Wire," Wall Street Journal, 3/10). He noted, "This is what budgeting is all about. It’s about making tough choices to fix our country's problems," adding, "We believe Obamacare will actually lead to hospitals and doctors and health care providers turning people away" ("Blog Briefing Room," The Hill, 3/10).

However, Ryan's call to repeal the ACA could put him at odds with GOP lawmakers who want to find common ground with President Obama to reduce the federal deficit, particularly after the Supreme Court upheld the law, according to the Los Angeles Times.

Ryan's FY 2014 budget proposal also includes a provision from his FY 2013 budget proposal to turn Medicare into a premium-support system, the Times reports. Under Ryan's plan, beneficiaries would receive a federal subsidy to purchase either private coverage or a traditional Medicare plan. Just like the 2013 plan, the 2014 blueprint also would rely on more than $700 billion in Medicare savings from the ACA to "make Medicare more solvent" (Mascaro, Los Angeles Times, 3/10).

Ryan said changing Medicare to a premium-support model "is the best way to save Medicare for future generations." He added, "This guarantees that Medicare does not change for people in or near retirement, and it also guarantees for those of us who are under the age of 55, that we actually have a Medicare program when we retire" (Zigmond, Modern Healthcare, 3/10).

In addition, Ryan said his budget blueprint would undo the ACA's Medicaid expansion and give states more control over their programs by turning Medicaid into a block-grant system, the Times reports (Los Angeles Times, 3/10). According to Ryan's budget, this would generate $770 billion in Medicaid savings over the next decade.

When asked if Obama would accept his proposed changes to Medicare and Medicaid, Ryan said, "My guess is he won't." However, he added, "I think there are things that we can do that don't offend either party's philosophy, that doesn't require someone to surrender their principles" (Brown/Sullivan, Washington Post, 3/10).