S8, Ep 24- Budget Tools or Policy Weapons? How Congress Shapes Health Care

What exactly are reconciliation and rescission—and why do they matter for your health? In this episode, Steven Newmark, Chief Policy Officer at GHLF, demystifies two powerful — and often misunderstood — budget tools: reconciliation and rescission. What do they mean? How do they bypass the normal budget process? And why do they matter for healthcare, public programs, and patients?

Steven breaks down the differences between these mechanisms, explains where they fit into the broader federal budget process, and examines Congress’s recent $9.4 billion rescission vote. If you care about how Congress funds — or defunds — healthcare, this episode will give you the clarity you need.

Tune in to learn:

• What reconciliation really is, and how it’s used to pass major healthcare policy
• Why rescission gives presidents the power to cancel already-approved spending
• How these tools operate outside the regular appropriations process
• What the latest moves in Congress mean for public health funding in 2025

Among the highlights in this episode:

01:15: Steven explains how budget reconciliation works, including its origins in the 1974 Congressional Budget and Impoundment Control Act

01:57: Steven breaks down why reconciliation is such a powerful tool: it allows bills to pass with a simple majority in the Senate

02:19: Steven introduces rescission, the process for canceling already approved spending, and details President Trump’s recent $9.4 billion rescission request

03:34: Steven discusses the impact of reconciliation and rescission on health care, including potential threats to Medicaid, Medicare, and public health programs

04:32: Steven warns that the use of rescission discourages bipartisan negotiation and risks undermining trust in the budget process

05:23: Steven urges listeners to stay informed, as funding for essential programs could quietly disappear without public scrutiny

05:35: Steven zooms out to explain how reconciliation and rescission fit within the larger federal budget process

06:49: Steven concludes by emphasizing the need for Congress to follow regular order and for advocates to understand budget mechanisms to be effective

Contact Our Host

Steven Newmark, Chief of Policy at GHLF: [e-mail]

A podcast episode produced by Ben Blanc, Director, Digital Production and Engagement at GHLF.

We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to [e-mail]

Listen to all episodes of The Health Advocates on our website (https://ghlf.org/the-health-advocates) or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.