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January 5, 2017

Senate kicks off process to repeal the Affordable Care Act

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Senate Budget Committee Chair Mike Enzi (R-Wyo.) on Tuesday introduced a budget resolution  that initiates Republicans' efforts to repeal the Affordable Care Act (ACA) through the budget reconciliation process.

The budget reconciliation process allows bills related to spending and revenue to be passed by a simple majority, without being subject to a filibuster. Republicans lack a filibuster-proof majority in the Senate, but hold 52 of the chamber's 100 seats.

Budget resolution details

The budget resolution instructs two House committees—the House Energy and Commerce and Ways and Means Committees—and two Senate committees—the Senate Committee on Finance and the Health, Education, Labor and Pensions Committee—to draft and approve legislation that, among other provisions, would repeal parts of the ACA. The resolution gives the committees until Jan. 27 to do so.

According to CQ News, the final repeal bill likely will be similar in many ways to a budget reconciliation measure (HR 3762) Congress approved last year that also would have repealed major parts of the ACA. President Obama vetoed that bill.

However, people familiar with the legislation say there could be some significant differences between the two measures, CQ News reports. For example, the new budget reconciliation measure could retain certain taxes included in the ACA, such as the so-called "Cadillac tax."

The budget resolution does not include specific details on a plan to replace the ACA. However, the resolution does include "reserve funds" that would allow lawmakers to use savings generated from repealing the ACA to help offset the cost of a replacement plan. The Congressional Budget Office previously estimated that repealing the ACA could produce about $500 billion in savings over 10 years.

Next steps

Senate Majority Leader Mitch McConnell (R-Ky.) is set to open debate on the budget resolution on Wednesday. The Senate likely will hold votes on the measure next week, CQ News reports.

If the Senate passes the resolution, the measure then would go to the House.


House Speaker Paul Ryan (R-Wis.) in a statement said the resolution "sets the stage for repeal [of the ACA], followed by a stable transition to a better health care system."

Senate Minority Leader Chuck Schumer (D-N.Y.) criticized Republicans for beginning the process to repeal the law without also offering a replacement plan. He said, "It's not acceptable to repeal the law, throw our health care system into chaos, and then leave the hard work for another day."

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Senate Majority Whip John Cornyn (R-Texas) said Republicans would like to work with Democrats on a replacement plan after completing the repeal process. "It would be good that once we repeal [the ACA] that we begin the process of building consensus again," he said, adding, "Surely, we can do much better than [the ACA] and we ought to invite our Democratic colleagues to work with us."

Trump adviser: No one will lose coverage

In related news, Kellyanne Conway, a top adviser to President-elect Donald Trump, said Trump's administration will aim to ensure all individuals who currently have health coverage under the ACA will remain insured under any Republican replacement plan, The Hill reports.

"We don't want anyone who currently has insurance to not have insurance," Conway said during an interview with MSNBC.

While Trump in several tweets on Tuesday called the ACA "lousy health care," Conway said Trump "is committed to retaining" the ACA provisions "his advisers say are working," such as ensuring coverage for individuals with pre-existing conditions.

Conway added that repealing and replacing the ACA simultaneously would be the "ideal situation," but said it "could take years to actually complete the process" (Kodjak, "Shots," NPR, 1/3; Cornwell/Chiacu, Reuters, 1/3; Bowman, Roll Call, 1/3; Carney, The Hill, 1/3; Modern Healthcare, 1/3; Hughes, Wall Street Journal, 1/3; Hughes/Peterson, Wall Street Journal, 1/3; Krawzak [1], CQ News, 1/3 [subscription required]; Krawzak [2], CQ News, 1/3 [subscription required]; Sullivan, The Hill, 1/3; Hellmann, The Hill, 1/3).

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