United States Congressman Bill Flores

Representing the 17th District of Texas

Actions taken to repeal, dismantle, and defund Obamacare
What has already been done regarding Obamacare? House Republicans have tackled Obamacare on all fronts and share the same end goal: full repeal. Below is a compilation of floor actions to fight Obamacare. To date, three programs have been completely halted. The 1099 tax reporting requirement and free choice vouchers were repealed by Congress and signed into law, and the Administration ceased implementation of the unworkable CLASS Act Program. Seven Obamacare provisions have been repealed / have had funding rescinded and signed into law: the onerous 1099 tax reporting requirement imposed on small businesses (and improper subsidies); FreeChoice Vouchers; and funding for the CO-OP, the IPAB rationing board, the Prevention and Public Health Slush Fund, and a Medicaid drafting fix for the Louisiana Purchase. 31 Floor votes have been taken to repeal, defund, or dismantle the law. Republicans won't stop there; we will continue to pursue strategic opportunities to get these and other de-funding and repeal bills to President Obama's desk. Floor Action On January 19, 2011, the House passed, H.R. 2, the Repealing the Job-Killing Health Care Law Act: One of the Houses first official actions was to repeal Obamacare in its entirety and instruct the committees of jurisdiction to begin work on finding common sense patient-centered replacement legislation. On February 19, 2011, the Housed passed H.R. 1, the Full-Year Continuing Appropriations Act, 2011: The House passed several substantial bipartisan amendments to H.R. 1 that would severely handicap implementation of Obamacare: The Rehberg Amendment #575: Provides that no funds in this Act may be may be used for any employee, officer, contractor or grantee of any department or agency funded in this title (Labor & HHS) to implement the health care provisions of Obamacare. (passed: 239-187) The King Amendment #267: Provides that no funds in this Act may be may be used to implement Obamacare. (passed: 241-197) The King Amendment #268: Provides that no funds in this Act may be may be used to pay officials who implement Obamacare. (passed: 237-191) The Emerson Amendment #83: Provides that no funds in this Act may be may used by the IRS to implement or enforce provisions on Obamacare related to the reporting of health insurance coverage. (passed: 246-182)

The Price Amendment #409: Provides that no funds in this Act may be used by HHS to implement or enforce the Medical Loss Ratio (MLR) provision. (passed: 241-185) The Burgess Amendment #200 would prohibit any funds in this Act to be used to pay the salary of any officer or employee of the Center for Consumer Information and Insurance Oversight (CCIIO). (passed: 239-182) The Pitts Amendment #430: Provides that no funds in this Act may be used for an officer or employee at HHS, IRS, and Labor to do any action to specify or define, through regulations, guidelines, or otherwise, essential benefits as required in Obamacare. (passed: 239-183) The Gardner Amendment #79: Provides that no funds in the Act may be used to pay the salary of any employee or officer of the HHS who develops or promulgates regulations or guidance regarding Exchanges under Obamacare. (passed: 241-184) The Hayworth Amendment #567: Provides that no funds in this Act may be used to implement the IPAB created under Obamacare. (Accepted by voice vote)

On March 3, 2011, the House passed H.R. 4, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011: H.R. 4, signed into law on April 14, 2011, repealed the job-killing Form 1099 reporting requirements that were added in Obamacare strictly as a way to help finance Obamacare. This provision has a real detrimental impact on small businesses and Americans believe it needs to be repealed. On April 13, 2011, the House passed H.R. 1217, to repeal the Prevention and Public Health Fund: H.R. 1217 The Prevention and Public Health Fund (PPHF) was established in Obamacare with a broad mandate for prevention, wellness, and public health activities. The Fund is administered by the Secretary of Health and Human Services (HHS), who has full discretion on how to spend funds without further Congressional action or oversight. This slush fund can go towards a variety of programs including jungle gyms, bike paths, and even lobbying activities. On April 14, 2011, the House passed H.R. 1473, the Department of Defense and Full-Year Continuing Appropriations Act, 2011: H.R. 1473, signed into law on April 15, 2011, tackled two programs created in Obamacare: repealed the Free Choice Voucher program and reduced funding for the Consumer Operated and Oriented Plan (CO-OP) by $2.2 billion. Additionally, the bill provided new tools to fight implementation and ensured no increase in IRS funding to hire additional agents to enforce the individual mandate. On April 14, 2011, the House passed H.Con.Res.35, Directing the Clerk of the House of Representatives to make a correction in the enrollment of H.R. 1473: In addition to the Obamacare repeal provisions included in H.R. 1473, the agreement reached allowed for two enrollment votes which guaranteed up-ordown Senate votes on key issues. One of the enrollment votes, H.Con.Res.35, defunded all mandatory and discretionary spending in Obamacare (including the $105 billion). On April 15, 2011, the House passed H.Con.Res.34, Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021: The Ryan Budget, titled, The Path to Prosperity among other things, repeals and defunds

Obamacare, ensuring that not a penny is spent on the government takeover of health care that was enacted last year. Instead, it moves toward patient-centered reform. On May 3, 2011, The House passed H.R 1213, to repeal mandatory funding provided to states in the Patient Protection and Affordable Care Act to Establish American Health Benefit Exchanges: H.R. 1213 repeals a provision created in Obamacare which provides the Secretary of Health and Human Services (HHS) with an unlimited tap on the U.S. Treasury for various activities related to government mandated health insurance exchanges. On May 4, 2011, The House passed H.R 1214, to repeal mandatory funding for school-based health center construction: H.R. 1214 repeals a provision in Obamacare which provided $200 million in mandatory funding (slush fund) through 2014 solely for construction (facilities and equipment) to build and renovate School-Based Health Centers (SBHCs). On May 24, 2011, The House passed H.R. 1216, to convert funding for graduate medical education in qualified teaching health centers from direct appropriations to an authorization of appropriations: H.R. 1216 converts $230 million in mandatory spending provided under Obamacare for residency programs to discretionary spending, allowing teaching health centers to receive funding through the regular appropriations process. On August 1, 2011, the House passed S.365, the Budget Control Act of 2011: S. 365, signed into law August 2, 2011, among other things would allow for yet another mechanism to cut Obamacare spending. Discretionary Spending Cuts: The overall discretionary caps, saving $840 billion over ten years, will allow for our appropriators to go after various wasteful programs already being funded and strengthen their hand for not including new Obamacare discretionary spending. Mandatory Spending Cuts: Remember that $105 billion you kept hearing about? Well since the $105 billion is made up of various programs considered mandatory spending, many would be subject to required across the board cuts or sequestration (if a balanced budget amendment or at least $1.2 trillion in mandatory and discretionary cuts proposed by the Joint Committee were not passed).

On November 16, 2011, the House passed the Senate Amendments to H.R. 674, To amend the Internal Revenue Code of 1986 to repeal the imposition of 3 percent withholding on certain payments made to vendors by government entities, to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs, and for other purposes: H.R. 674, signed into law on November 21, 2011, among other things, required certain benefits to be included in the calculation of modified adjusted gross income (MAGI) for purposes of determining eligibility for certain health care programs under Obamacare. Without this change According to the Center for Medicare and Medicaids (CMS) Chief Actuary, a couple earning $64,000 could still qualify for Medicaid. On December 13, 2011, the House Passed H.R. 3630, the Middle Class Tax Relief and Job Creation Act of 2011: H.R. 3630 offset the cost of extending the payroll tax reduction, unemployment Insurance, and doc fix through Obamacare subsidy recapture and reduction to the public prevention slush fund, among other provisions.

On December 16, 2011, the House Passed the Conference report for H.R. 2055, the Consolidated Appropriations Act, 2012 Consolidated Appropriations Act, 2012: H.R. 2055, signed into law on December 23, 2011, rescinded $400 million from Obamacare CO-OPs and $10 million in funds for IPAB (rationing board). The bill also reduced IRS funding by $305 million from FY11 levels, hampering enforcement of the Obamacare revenue provisions including the individual mandate and tightens CDC restriction on using grant money to lobby (Prevention and Public Health slush Fund). On February 1, 2012, the House Passed H.R. 1173, the Fiscal Responsibility and Retirement Security Act of 2011: H.R. 1173 repeals the government-administered long term care insurance program, the Community Living Assistance Services and Supports (CLASS) Act, created in Obamacare. The CLASS Act is a microcosm for the problems in Obamacare (budget gimmick, insolvent, done behind closed doors and rushed into law, massive new unsustainable entitlement), a provision that was used to disguise the short-term costs of the broader bill through a budget gimmick. On February 17, 2012, the House passed the Conference Report to H.R. 3630, the Middle Class Tax Relief and Job Creation Act of 2012: H.R. 3630, signed into law on February 22, 2012, clawed back a total of $11.6 billion from Obamacare including $5 billion in cuts to the Prevention & Public Health Slush Fund and recouping $2.5 billion by correcting a drafting error that allowed Louisiana to receive excess Medicaid funding via the Louisiana Purchase in Obamacare. On March 22, 2012, the House passed H.R. 5, the Protecting Access to Healthcare Act (PATH): H.R.5 repeals the Independent Payment Advisory Board (IPAB), a panel of 15 unelected and unaccountable government bureaucrats tasked with reducing Medicare costs through arbitrary cuts to providers resulting in de facto rationing of care for seniors. Additionally, the bill enacts medical liability reform that will save Medicare money through reducing liability insurance and the practice of defensive medicine while still ensuring access to care. On March 29, 2012, the House passed H.Con.Res.112, Establishing the budget for the United States Government for fiscal year 2013 and setting forth appropriate budgetary levels for fiscal years 2014 through 2022: The Ryan Budget, titled, The Path to Prosperity among other things, repeals and defunds Obamacare, ensuring that not a penny is spent on the government takeover of health care that was enacted two years ago. Instead, it moves toward patient-centered reform. On April 27, 2012, the House passed H.R. 4628, the Interest Rate Reduction Act: H.R.4628 prevents, for one year, certain federally subsidized student loan interest rates from increasing on July 1, 2012, offset by repealing the Prevention and Public Health Slush Fund (PHHF), created in Obamacare. On May 10, 2012, the House passed H.R.5652, the Replacement Reconciliation Act of 2012: H.R. 5652 replaces arbitrary across-the-board cuts to defense and other discretionary non-defense programs with common-sense reforms, including the following Obamacare provisions: Eliminate Prevention and Public Health Slush Fund: $11.9 billion over ten years Repeal unlimited state Exchange grants: $13.5 billion over ten years Defund the CO-OP program: $880 million over ten years Rebase the Disproportionate Share Hospital (DSH) allotments in FY2022: $4.2 billion over ten years Repeal the Medicaid Maintenance of Effort (MOE) requirement imposed on states: $590 million over ten years Repeal the increased federal Medicaid funding cap and match rate for territories: $6.3 billion over ten years

Repeal of bonus payments for states for increasing their Medicaid enrollment: $400 million over ten years Fully recapture Exchange subsidy overpayments: $43.9 billion over ten years

On June 7, 2012, the House passed H.R. 436, Health Care Cost Reduction Act of 2012: H.R. 436 removes harmful limitations put in place by Obamacare, save up to 47,000 jobs, support medical innovation, reduce health care costs, and provide American families more choice and flexibility. The bill repeals the medical device tax, limitations on reimbursement of the over-the-counter medications from various tax-advantaged accounts for health care and the Exchange subsidy overpayments. On July 11, 2012, the House passed H.R. 6079, Repeal of Obamacare Act: H.R. 6079: H.R. 6079 would repeal the Patient Protection and Affordable Care Act of 2010, and Title I and subtitle B of Title II of the Health Care and Education Reconciliation Act of 2010. Obamacare expands government control over health care, adds trillions of dollars to existing liabilities, drives costs up even further, and too often put Federal bureaucrats, instead of doctors and patients, in charge of health care decision making. The path to patientcentered care and lower costs for all Americans must begin with a full repeal of the law.