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The House last night voted 228-199 to approve a  for fiscal year 2016, which calls for reducing overall spending by $5.5 trillion over the next 10 years to balance the federal budget. The budget proposal would reduce Medicare spending by $148 billion and Medicaid and other health care spending by $913 billion over 10 years. It would repeal the Affordable Care Act, including the Independent Payment Advisory Board charged with making coverage decisions on Medicare; create and implement a “premium support” Medicare model, allowing beneficiaries to remain in “traditional Medicare” or transition to the new model; combine Medicare Parts A and B to create a single deductible for seniors; make reforms to medical liability laws to curb frivolous lawsuits; and repeal the Medicare physician sustainable growth rate formula. In addition, the proposal would repeal Medicaid expansion under the ACA; create a block grant program giving states flexibility to tailor the Medicaid program to their communities; and unify Medicaid and the State Children’s Health Insurance Program into a single program. The Senate began voting on amendments to its  today.