The U.S. House of Representatives today voted 221-207 to pass a fiscal year 2014 budget resolution that would cut more than $4.6 trillion in government spending over the next 10 years. About $2.7 trillion of the spending reductions would come from health care, much of which is achieved by savings attributed to repealing the coverage provisions of the Patient Protection and Affordable Care Act while maintaining the ACA’s reductions. The budget plan also recommends reforming the medical liability system; increasing means testing for Medicare Parts B and D; repealing the Independent Payment Advisory Board; and establishing a deficit-neutral reserve fund to address the “doc-fix.” Starting in 2024, Medicare would transition to a premium support program, with workers currently under age 55 choosing between private plans and a traditional fee-for-service option through a newly created Medicare Exchange. The budget also would convert Medicaid into a block grant program and reduce federal Medicaid spending by $756 billion over 10 years. The Senate is expected to consider its own budget resolution later this week.