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Congress Adopts a Budget That Can Undermine Health Care and HIV Programs

October 31, 2017

The House of Representatives on Thursday voted, by a narrow margin, to adopt the Senate's FY 2018 budget resolution. The vote was 216-212, with 20 Republicans voting "No," along with all the Democrats. Passing the same resolution that the Senate passed last week was a crucial step in moving congressional Republicans along in trying to achieve their, and the president's, prime goal of a major overhaul of the tax code. The adopted resolution, which effectively is now the required joint budget resolution, includes a parliamentary procedure known as reconciliation that allows tax legislation to pass in the Senate with a simple 51-vote majority, avoiding a likely filibuster by Senate Democrats.

If the actual tax bill follows, as expected, the framework that congressional Republican leaders and White House officials released a few weeks ago, it will mean huge benefits for corporations and the wealthiest of households and could include some tax increases for middle class and working class households. If the anticipated tax cut bill is enacted, it will also lead to massive spending cuts starting next year, FY 2019, that will devastate health care programs and Medicaid and derail efforts to end the HIV epidemic.

The adopted FY 2018 budget resolution allows Congress to pass tax cuts that would add a total of $1.5 trillion to the deficit over 10 years. Such a deficit-financed tax cut represents a convenient abandonment of long-held Republican principles on the imperative to reduce deficits and reduce the total federal debt. This hypocritical moment is likely to be temporary, however. The same legislators who this week ignored the deficit and federal debt likely will revert to form next year and express their shock at the rising deficits and demand spending and entitlement cuts to reduce the deficit. Indeed, the FY 2018 budget resolution provides a roadmap for such cuts, calling for $5.8 trillion in program spending cuts over the next 10 years. The cuts include nearly $2 trillion in cuts to Medicaid, Medicare and other health care entitlement programs and $800 billion in cuts below the severe caps set by the Budget Control Act.

This intent to enact draconian cuts was boldly made clear in interviews that some members of the House Budget Committee recently gave to Roll Call. After interviewing half a dozen House Budget Committee members and speaking with several other fiscal hawks in the GOP conference, Roll Call reported that, "they all said they anticipate mandatory spending cuts being a priority for the fiscal 2019 budget reconciliation process."

A deficit-financed tax cut bill is expected to be released next week -- on November 1st -- according to House Ways and Means Committee Chairman Kevin Brady (R-TX). The Republican leadership plans to speed the legislation through both the House and Senate and to have it on the president's desk by Thanksgiving. The closeness of this week's House vote on the budget resolution, and the serious concerns raised by the Republicans who voted against it, suggest that the path to a tax cut that benefits corporations and the very wealthiest households may not be easy.

Given the implications for big spending cuts starting next year, HIV advocates should join the broad coalition of groups opposing tax legislation that harms middle class and working families and that undermines funding for domestic entitlement programs, including Medicaid and HIV programs. The success that was achieved in stopping the rush to repeal and replace the Affordable Care Act shows that harmful legislation that was thought to be a slam dunk can be stopped. The congressional Republicans' and the president's desperation to pass a tax cut cannot, and should not, be dismissed. It can only be matched, and overcome, by the steadfast determination of advocates for economic and social justice and health care as an essential human right. We can do this.   

[Note from This article was originally published by AIDS United on Oct. 27, 2017. We have cross-posted it with their permission.]

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This article was provided by AIDS United. Visit AIDS United's website to find out more about their activities and publications.

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