Sound and fury ex­pected on fast-track ACA re­peal

Modern Healthcare - - THE WEEK AHEAD - —Bob Her­man

Fri­day is the Repub­li­cans’ self-im­posed dead­line to es­tab­lish a fast-track bud­get pro­ce­dure to re­peal the Af­ford­able Care Act. But the process likely will play out more as po­lit­i­cal theater than as a gen­uine threat to the law.

Ear­lier this year, Repub­li­cans teed up a pro­ce­dure called rec­on­cil­i­a­tion to en­able the Se­nate to avoid a Demo­cratic fil­i­buster and pass re­peal leg­is­la­tion by a sim­ple ma­jor­ity. Repub­li­cans in­cluded rec­on­cil­i­a­tion in this spring’s bud­get dis­cus­sions for the “sole pur­pose of re­peal­ing the pres­i­dent’s job-killing healthcare law,” ac­cord­ing to a House res­o­lu­tion. While the GOP set a July 24 tar­get date to start the process, there are no con­se­quences for miss­ing it, said Eric Zim­mer­man, a part­ner at McDer­mott Will & Emery. If con­gres­sional com­mit­tees aren’t ready to put some­thing for­ward, they still can do so later, in­clud­ing af­ter the Au­gust re­cess.

Repub­li­cans know that even if they pass a re­peal bill, Pres­i­dent Barack Obama will veto it. “It’s part of ful­fill­ing cam­paign prom­ises and set­ting the stage for 2016 pres­i­den­tial and con­gres­sional elec­tions,” Zim­mer­man said.

Even piece­meal re­peal will be tough de­spite bi­par­ti­san sup­port on some is­sues. For ex­am­ple, some Democrats have co-spon­sored leg­is­la­tion to nix the law’s taxes on med­i­cal de­vices and high-value em­ployer health plans. Obama likely would veto such mea­sures, and Congress prob­a­bly can’t muster the votes to over­ride him.

“The pres­i­dent has ap­peared more em­bold­ened since the King de­ci­sion (up­hold­ing pre­mium sub­si­dies) and more re­sis­tant to any change that un­der­mines the fi­nanc­ing” for the ACA, Zim­mer­man said.


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