Senator Mike Enzi (R-WY), Chairman of the Senate Budget Committee, introduced a concurrent budget resolution on Tuesday that could pave the way for repeal of the Affordable Care Act (ACA).
The resolution includes instructions for committees in the Senate and House of Representatives to follow in order to put repeal through reconciliation, a “fast-track process” requiring only a simple majority in the Senate, as well as in the House.
- These committees will have until January 27 to draft reconciliation bills, which will be combined into a single bill to be considered by both chambers.
Republicans have made good on their promise to begin working toward repeal of the ACA early in 2017. The resolution was introduced on the same day that members of the 115th Congress were sworn into office.
The budget resolution gets the ball rolling on repeal, but Republicans still need to work out the details. For instance, their current plan is to delay the effective date of repeal, but there is disagreement over how long that delay should last. House Republicans seem to favor a delay of two years, although there have been discussions about delaying repeal until after the 2020 elections, Vox reported.
Efforts to repeal the ACA could also face resistance from some Republican legislators. As the reality of repeal and delay becomes more apparent without a clear replacement consensus, some Republicans worry about the effects such a maneuver could lead to. For example, Joe Antos and James Capretta, both who have ties to the conservative think tank American Enterprise Institute, wrote yesterday in a Health Affairs Blog post that they do not support the repeal and delay approach. "The most likely end result of 'repeal and delay' would be less secure insurance for many Americans, procrastination by political leaders who will delay taking any proactive steps as long as possible, and ultimately no discernible movement toward a real marketplace for either insurance or medical services," they wrote.
The AMA released a statement yesterday where AMA CEO Dr. James Madara stated the ACA is "imperfect" but that it is "essential that gains in the number of Americans with health insurance coverage be maintained" and policymakers should lay out "in reasonable detail" what policies will replace the measure before action through reconciliation is taken.
Details regarding Republican plans for health reform have been murky since the presidential election on November 8. However, it appears that those details could become clearer over the next month.
One of the best guesses as what the reconciliation bill would look like is H.R. 3762, the ACA repeal reconciliation bill that President Barack Obama vetoed early last year. Though at the time it was known that the bill would get shot down. This effort has real consequences which should give some pause to legislators for what should actually be included and what the effects may be. A senator who spoke with Bloomberg on the condition of anonymity noted "there’s a growing sense among some of his colleagues that they need to have a replacement for Obamacare ready soon 'because we’re going to own this.'"
While Democrats will be unable to stop repeal through the budget reconciliation process if all Republicans are on board, they are planning a public relations campaign to highlight the consequences of repeal.