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Medicaid, Medicare, preventive medicine, help to the states to set up exchanges—all are on the Republicans' chopping block. House committees are meeting this week to decide which specific programs to cut, per the Mitt Romney-endorsed Ryan budget they all so enthusiastically embraced. The Appropriations Committee set the spending limit at $150 billion. That is $7 billion less than what the Senate is working with, as specified in last year's Budget Control Act.

What that means is a lot of critical programs, and incidentally a lot of health care jobs, would be history.

One cut in particular is meant to block states' ability to set up insurance exchanges using funds from the Health and Human Services (HHS) Department. [...]

Other GOP amendments specifically directed at the healthcare law would repeal its "prevention" fund and rescind money for loan subsidies to nonprofit insurance plans.

Proposals directed at Medicaid would lower its funding cap, cut its payments to the territories and give states new leeway to cut eligibility.

Obamacare repeal, Medicaid block grants, preventive medicine out the door; it's a tea party dream! Bootstraps, people. Only the strong (and healthy and not-accident-prone) survive. This is just the beginning of a 10-year, nearly $3 trillion set of cuts (not counting Medicare) that would nuke the health care safety net.

This vision, of course, won't survive legislatively. The Senate won't accept it and President Obama would veto it. It will, however, be central to the showdown with the Senate and White House that could lead to a government shutdown. We won't know until November if it'll survive politically, but the combination of the unpopular cuts and the brinksmanship on shutdowns aren't likely to help Republicans.

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