In it, but not of it. TPM DC

Democrats Welcome Health Care Spending Fight With Republicans


"I think the things that they would attack now are things that are direct services to American people," said Rep. John Yarmuth (D-KY). "They would have to start saying, well we're going to wack the spending for the donut hole, and for preventive care, and for things that are direct services to American citizens."

Some Republicans want to use the appropriations process to block the IRS from administering the mandate, and the Department of Health and Human Services from helping states set up insurance exchanges ahead of 2014.

"What are they going to cut? There's very little administrative costs being expended, I mean you could do it, but they'd find ways to shuffle money around in the department," Yarmuth said.

To illustrate the conundrum, Yarmuth pointed out that the law expands Medicaid to cover people up to 133 percent of the poverty line, and that the federal government pays for that expansion through the end of the decade.

"You're going to go in and now say to states 'you've got to provide the service now -- that's in the law -- but we're not paying you,'" he said.

"We'll just see how irresponsible [Republicans want to be]," Pelosi said.

About The Author


Brian Beutler is TPM's senior congressional reporter. Since 2009, he's led coverage of health care reform, Wall Street reform, taxes, the GOP budget, the government shutdown fight and the debt limit fight. He can be reached at