On May 10, 2012, the House of Representatives approved H.R. 5652, the Sequester Replacement Reconciliation Act of 2012, on a largely party-line vote. The legislation would replace certain across-the-board cuts to defense and domestic spending scheduled to begin in 2013 under last year’s Budget Control Act with a new package of domestic spending reductions made through the budget reconciliation process (note that the scheduled 2% across-the-board cut to Medicare provider payments would be retained). Among many other things, the House bill would: repeal certain ACA funding (including the Prevention and Public Health Fund, funding for the Consumer Operated and Oriented Plan program, funding for state insurance exchanges, and state bonus payments for increasing Medicaid enrollment); repeal ACA Medicaid maintenance of effort requirements; revise Medicaid provider tax provisions; and provide for various medical malpractice reforms.  The Obama Administration strongly opposes the House bill, and consideration in the Senate is unlikely.  Any legislative action to block the scheduled sequestration and revise spending/tax policy is not expected until much later in the year – potentially after the November elections.