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."

About The Author


Sahil Kapur is TPM's senior congressional reporter and Supreme Court correspondent. His articles have been published in the Huffington Post, The Guardian and The New Republic. Email him at and follow him on Twitter at @sahilkapur.