Republicans have woven sections that could shape efforts to change the Affordable Care Act and improve Social Security Disability Insurance program solvency into the rules that will govern House operations in the 115th Congress.
The House Republican Conference, a body that includes all Republican House members, put the ACA and Social Security disability sections in House Resolution 5, a package of procedural rules.
House members approved the package by a vote of 234 to 193.
The ACA section appears in a collection of rules that would govern how the House handles a budget reconciliation resolution.
Republicans hold just 52 seats in the Senate. Getting legislation through the Senate normally takes 60 votes. Budget reconciliation is a process that lawmakers can use to get budget-related measures through the Senate with just 51 votes.
House Resolution 5 prohibits most budget reconciliation package provisions that would lead to more than $5 billion in additional direct federal spending over any 10-year period from 11 years to 50 years in the future. If a measure could be passed in 2017, for example, analysts would have to verify that the measure would lead to less than $5 billion in extra federal spending for the period from 2027 through 2036; for the period from 2037 through 2046; for the period from 2047 through 2056; and for the period from 2057 through 2066.
The provision contains an exemption for measures that would repeal or reform the "Patient Protection and Affordable Care Act and title I and subtitle B of title II of the Health Care and Education Affordability Reconciliation Act of 2010."
The provision means that supporters of efforts to repeal or change the ACA could get a change that would cost more than $500 million per year into a budget reconciliation package.