GOP sen­a­tors fac­ing pro­ce­dural chal­lenges in re­peal­ing key Af­ford­able Care Act pro­vi­sions

Modern Healthcare - - THE WEEK AHEAD - —Shan­non Much­more

As Congress re­turns from the short hol­i­day break, sen­a­tors will con­tinue push­ing a bill that would re­peal key parts of the Af­ford­able Care Act, de­spite tech­ni­cal and po­lit­i­cal dif­fi­cul­ties and a cer­tain veto.

GOP sen­a­tors had a plan to fast-track the bill, which would re­peal the ACA’s in­di­vid­ual and em­ployer health in­sur­ance man­dates as well as the med­i­cal-de­vice tax and the “Cadil­lac” tax on high-end in­sur­ance plans. That bill passed through the House with the bud­get rec­on­cil­i­a­tion process.

But the par­lia­men­tar­ian ruled the bill would not have a direct enough bud­get im­pact for that method. That means the bill needs 60 votes to pass the Se­nate, in­stead of a sim­ple ma­jor­ity. Se­nate Repub­li­cans have sched­uled a con­fer­ence meet­ing for Mon­day evening with the idea of pre­sent­ing a new version of their bill, which would roll back or elim­i­nate the ACA’s ex­change sub­si­dies and Med­i­caid ex­pan­sion, by Dec. 2.

They in­di­cated the bill would be changed enough to get ap­proval from the par­lia­men­tar­ian for us­ing the rec­on­cil­i­a­tion process. Se­nate Ma­jor­ity Leader Mitch McCon­nell (R-Ky.) says he’s de­ter­mined to get a bill to Pres­i­dent Barack Obama, who has said he would veto any re­peal ef­fort. Three GOP sen­a­tors, in­clud­ing pres­i­den­tial can­di­dates Marco Ru­bio of Florida and Ted Cruz of Texas, have said they would not sup­port the bill be­cause it does not go far enough in re­peal­ing the ACA. A few more cen­trist Repub­li­can sen­a­tors have wa­vered be­cause of pro­vi­sions that would de­fund Planned Par­ent­hood.

Ed­win Park, vice pres­i­dent for health pol­icy at the left-lean­ing Cen­ter on Bud­get and Pol­icy Pri­or­i­ties, said the rec­on­cil­i­a­tion at­tempt could be fur­ther com­pli­cated by the Dec. 11 dead­line for a bud­get agree­ment, but it could be de­layed even fur­ther. “This could be post­poned to Jan­uary or be­yond,” he said.


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