What Now for ACA Repeal & Replace?

GOP Abandons ACA Repeal & Replace Efforts

Republicans worked hard this past weekend on revisions to the Graham-Cassidy bill in a last ditch effort to replace and repeal the Affordable Care Act, also known as Obamacare. However, their work fell short, despite last minute tweaks made to sweeten the deal for skeptics such as Alaskan Republican Sen. Lisa Murkowski, who had voted against the skinny-repeal earlier in the year and had voiced concern that Alaskans would be hurt by the new bill.

Republicans were not able to garner the 50 votes needed to guarantee passage of the bill before the end of the month through budget reconciliation, which does not require any votes from the opposing party. Earlier this month, Senators John McCain (AZ), Rand Paul (KY), and Susan Collins (ME) indicated they would not support the bill. On Tuesday, Senate Republican leaders announced that they would not put the bill to a vote.

The revised bill would have provided additional funding for states, including Alaska, Arizona, Kentucky, and Maine. However, while it bumped up funding percentages, a concern about losses in Medicaid to those states were key factors contributing to opposition to the bill.

In addition to concerns over Medicaid cuts, several senators cited a lack of Congressional Budget Office (CBO) analysis, although supporters had argued that most provisions of the bill had already been scored from previous versions. In addition, conservatives argued that the bill didn’t remove enough of the ACA regulations for a true repeal.

History of Trump-Era Repeal and Replace Efforts

In March and April, the House released several versions of the American Health Care Act (AHCA), which was the first of several attempts to repeal and replace Obamacare. Both would have reduced the federal deficit and eliminated the individual mandate, while keeping limited features of the ACA, including pre-existing conditions and parental coverage of adult children to age 26. The Senate version, the Better Care Reconciliation Act (BCRA), was similar to the House bill, but offered income-based tax credits and deeper cuts to Medicaid. The House bill passed, and although the Senate approved a motion to proceed with the BCRA, it was ultimately rejected.

Future Repeal and Replace Plans?

Republicans have expressed a desire to revisit efforts to repeal and replace the ACA in 2018, again using the budget reconciliation progress. Senator Lamar Alexander (R-WA) said he would consult with Democrats to craft a bipartisan bill. Democratic Senator Patty Murray (WA) expressed similar sentiments about working across the aisle.