Stymied in those broader attacks on health care, Republicans managed Tuesday to include a provision to undo the law’s tax paperwork requirement.
Sen. Orrin G. Hatch, Utah Republican, said it is “a down payment on total repeal of the onerous health care law.”
The measure passed the Senate by a 87-12 vote and was sent to Mr. Obama, whose administration had opposed the bill’s changes to the way subsides in the exchange are funded. Democrats said the changes could make people less eager to take part in the exchanges.
“We are pleased Congress has acted to correct a flaw that placed an unnecessary bookkeeping burden on small businesses,” he said.
The measure has become known as the “1099 repeal” because it would relieve businesses of having to file 1099 tax forms for any person or company they pay at least $600 in a year. It was designed to stop tax cheats, and was projected to raise billions of dollars, which were to be used to fund new health care benefits.
In order to make up for that money in their repeal, House Republicans rewrote the way the government would pay for subsidies under the new health exchanges in the law.
Under current law, consumers are allowed to keep much of the money when the government overpays them, but the new bill would claw back most of that money from taxpayers.
The budget calls for repealing the law and making fundamental changes in existing health care programs such as Medicare and Medicaid.
Mr. Ryan would convert Medicaid, the state-federal low-income health program, into block grants to states, and would restructure Medicare, the federal health program for seniors, so that retirees would choose from among a series of private plans and have costs be covered by the government.
Democrats said those plans would hurt the poor and elderly who rely on them.
“It is not courageous to protect tax breaks for millionaires, oil companies, and other big money special interests while slashing our investments in education, ending the current health care guarantees for seniors on Medicare, and denying health care coverage to tens of millions of Americans,” said Rep. Chris Van Hollen, the ranking Democrat on the Budget Committee.
Mr. Ryan acknowledged he may be “giving our political adversaries a weapon to use against us,” but said the payoff of having the debate will be worth it.
“This is not a budget — this is a cause,” he said.