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GOP Senate, House differ on Medicare savings


Senate Republicans are putting down a marker with their budget blueprint, one day after the House GOP unveiled a 10-year plan that boosts the military, makes deep cuts in social programs that include Medicare and targets President Barack Obama’s laws on health care and financial reforms.

The companion measure contains greater cost cuts to Medicare — $431 billion over the coming decade, which matches Obama’s savings if not his policies — but doesn’t call for the dramatic transformation of the program for future beneficiaries that House Republicans are pushing.

The House plan reprises deep cuts to social programs such as Medicaid, food stamps and student loans as well as a controversial plan that would transform Medicare into a voucher-like program for seniors joining in 2024 or later. They would receive a subsidy to purchase health insurance on the private market.

To meet their promise to balance the budget within a decade, Republicans propose cutting $5.5 trillion from a federal budget that’s on track to total $50 trillion over that period. More than $2 trillion would come from repealing health care coverage provided by Obama’s health care law.

Budget Committee Chairman Tom Price, R-Ga., said the GOP plan would “result in a government that’s more efficient and effective and accountable — one that frees up the American spirit … to do great things and to meet great challenges.”

The latest House budget plan opened to mixed reviews from GOP defense hawks and brickbats from Democrats.

“Let’s just be honest and say we’re adding this much money to the deficit,” said Rep. Raul Labrador, R-Idaho, referring to an ongoing effort by GOP leaders to fix the flawed Medicare payment formula without fully paying for it.

The House plan also would account for almost $1 trillion in higher tax revenue over a decade by assuming the expiration of popular tax breaks — known collectively in Washington-speak as tax “extenders” — such as for research and development. Republicans also promise to eliminate $1 trillion or so in so-called Obamacare taxes such as a looming tax on high-end “Cadillac” coverage but assume unspecified tax increases to make up for the revenue loss.

The nonbinding measure sets broad goals on spending cuts and taxes but requires follow-up legislation. Republicans have consistently voted for its cuts in the abstract but haven’t in many cases even drafted bills that would implement its most controversial cuts, much less try to pass them.

While promising balance by 2024, the GOP plan is likely to increase spending next year as Republicans prevent cuts in Medicare payments to doctors and work their way around tight Pentagon spending limits.

The blueprint by Price would add about $15 billion to Obama’s request for overseas operations and would allow $21 billion more if matched by offsetting spending cuts. That didn’t sit well with deficit hawks, who say it doesn’t guarantee enough money for the Pentagon, whose core budget essentially faces a freeze for the third year in a row with the return of automatic budget cuts known as sequestration.

“This is a very serious issue. We can’t address it through funny money in the budget. There needs to be an increase in the baseline number and I hope the Budget Committee hears that message,” said Rep. Michael Turner, R-Ohio. “Obviously they’re going to have difficulty trying to put together the votes for a budget that underfunds defense.”

Senate Republicans, aides said, won’t follow the House’s example and add to Obama’s $58 billion request for military operations and diplomatic efforts in the overseas war on terrorism as a way to skirt tight budget limits on the Pentagon.

Price is also replicating Rep. Paul Ryan’s approach to cutting Medicaid and food stamps by proposing to transform them from federal programs into wholly state-run programs that receive lump sum funding from the government. Ryan, R-Wis., was the previous Budget Committee chairman.

Cuts to Medicaid would exceed $800 billion, said Rep. Chris Van Hollen of Maryland, top Democrat on the Budget Committee, who noted that more than half of Medicaid funds pay for nursing home care for the elderly poor.

Senate Republicans will propose greater flexibility for states to run Medicaid but not the lump sum approach of the House.

The House plan also takes aim at the 2010 Dodd-Frank financial reform law and Obama’s health care law.

“If this budget actually got close to reality, I think that they’re going to have a lot of Republicans ultimately run away from it,” Van Hollen told reporters Tuesday.

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