In it, but not of it. TPM DC

GOP Snatches 'Obamacare' Cuts As Payroll Fight Wraps Up


Repeals key parts of ObamaCare and includes other health savings

--Cuts to ObamaCare pay for more than half ($11.6 billion) of the Medicare spending in the agreement.

--Cuts an ObamaCare slush fund (the Harkin Prevention Fund) by $5 billion.

--Eliminates an ObamaCare giveaway to Louisiana saving $2.5 billion.

--Reduces Medicaid spending (DSH rebase) by more than $4 billion.

--Other health savings total $9.6 billion and include reductions to Medicare "bad debt" and clinical laboratory payments

A senior Democratic aide downplayed the cuts, telling TPM that "these are mostly consensus items that don't touch benefits."

Progressive Democrats including Sen. Tom Harkin (IA), who championed the $15 billion prevention fund, won't be happy it's taking a hit. But Republicans more or less had Dems cornered because President Obama offered to cut the fund in his September deficit-reduction blueprint -- he proposed a $3.5 billion reduction but the GOP ran with it and got more.

The agreement also rolls back a special Medicaid funds deal for Louisiana, which critics decry as a backroom deal to win the vote of centrist Sen. Mary Landrieu (D-LA), and supporters say was necessary to help a state that's still reeling from Hurricane Katrina. It additionally cuts Medicaid pay bumps for hospitals with a high proportion of uninsured patients.

The money will be used for a 10-month override of the 27.4 percent cuts to Medicare physician reimbursements scheduled for March 1.

Update: A Dem aide adds some context, emailing: "Democrats stopped Republicans efforts to cut benefits for Medicare beneficiaries and to undermine health coverage for millions of Americans and now the GOP is trying to spin that away."