February 3, 2017

Why some Republicans aren't talking about 'replacing' the ACA anymore

Daily Briefing

Some Republican lawmakers are moving away from their "repeal and replace" rhetoric for the Affordable Care Act (ACA) and instead are adopting language that emphasizes "repairing" the law.

The change in rhetoric comes as GOP lawmakers struggle to agree on plans to repeal and replace the law, the Associated Press reports. Frank Luntz, a Republican consultant and pollster who addressed GOP lawmakers at their recent retreat, said the word repair "captures exactly what the large majority of the American people want."

Background on repeal, replace efforts

Last month, Congress approved a budget resolution that initiated the process for Republicans to repeal the ACA through the budget reconciliation process. The resolution instructs two House committees and two Senate committees to draft and approve a budget reconciliation measure that would include provisions to repeal certain parts of the ACA.

The resolution instructed the committees to draft and approve the legislation by Jan. 27, but the committees failed to meet that nonbinding deadline. Interim House Budget Committee Chair Diane Black (R-Tenn.) has said she now expects the two House committees to present reconciliation legislation later this month. The timeline in the Senate is less clear.

House Speaker Paul Ryan (R-Wis.) during GOP lawmakers' annual policy retreat last month said Republicans would seek to repeal and replace parts of the ACA by the spring.

However, an audio recording of a meeting at the retreat that was leaked to the press revealed that some GOP lawmakers do not agree on plans to repeal and replace the law. For example, lawmakers raised concerns about dismantling the ACA on such a fast timeline, as well as how their efforts to only repeal parts of the ACA could inadvertently destabilize the insurance market.

Changing rhetoric

 According to Bloomberg, Republicans during their policy retreat discussed using the word repair as a better way to brand their health reform plans, and several Republican lawmakers have since adopted the language.

While Republicans maintain that they still plan to repeal the ACA, some increasingly are discussing "repairing" the law as they work through their party's impasse, the Associated Press reports.

Sen. Paul unveils ACA replacement proposal

For instance, Senate Health, Education, Labor, and Pensions Committee Chair Lamar Alexander (R-Tenn.) during a committee hearing Wednesday said he thinks of the ACA "as a collapsing bridge," adding, "You send in a rescue team and you go to work to repair it so that nobody else is hurt by it and you start to build a new bridge, and only when that new bridge is complete ... do you close the old bridge." He continued, "No one is talking about repealing anything until there is a concrete practical alternative to offer Americans in its place."

House Energy and Commerce Committee Chair Greg Walden (R-Ore.) and Sen. Ron Johnson (R-Wis.) have voiced similar sentiments, The Hill reports. Walden said, "I'm trying to be accurate on this that there are some of these provisions in the law that probably will stay, or we may modify them, but we're going to fix things, we're going to repair things."

Republicans still committed to repeal

Despite some Republicans' change in rhetoric, GOP leaders say the party remains committed to dismantling the ACA.

Vice President Pence in a Fox News interview on Thursday said, "We are absolutely committed to follow through on President Trump's directive to repeal and replace [the ACA] and to have the Congress do it at the same time."

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In addition, Ryan during an appearance on "Fox & Friends" Thursday sought to clarify the change in rhetoric and the GOP's stance, emphasizing that repair is the same as replace. "There's a miscommunication going on," he said, adding, "If we're going to repair the U.S. health care system ... you must repeal and replace [the ACA]."

Separately, Rep. Jim Jordan (R-Ohio) said, "We are looking to repeal this law, just like we told the voters we were going to do, just like we promised them we would do. After all, there was an election where that was one of the most important issues."

Other Republicans expressed concern about talk of "repairing" the ACA, the Washington Post's "PowerPost" reports. For instance, House Freedom Caucus Chair Mark Meadows (R-N.C.) said, "If you're talking about repairing the [ACA], it's unrepairable. We need to repeal it. We need to replace it. If you want to call that a repair, so be it, but I don't know that that makes it any more palatable to the folks back home."

Meanwhile, Sen. Orrin Hatch (R-Utah) on Thursday said he was open to either repealing or repairing the law. "Anything that will improve the system, I'm for," he said.

Reps. push for vote on ACA repeal bill

In related news, two House Republicans are calling on their party's leaders to again consider a bill (HR 3762) to repeal the ACA that Congress approved last year but was then vetoed by former President Barack Obama, The Hill reports.

Meadows and Jordan in a statement Thursday called on GOP leaders to hold another vote on HR 3762, citing concerns that Republicans instead might pursue a measure that would repeal fewer ACA provisions.

The lawmakers said Republicans "committed to the American people to repeal every tax, every mandate, the regulations, and to defund Planned Parenthood." They added, "That's what the American people expect us to do—and they expect us to do it quickly."

(Fram/Alonso-Zaldivar, AP/Sacramento Bee, 2/3; Pear/Abelson, New York Times, 2/2; Snell/DeBonis, "PowerPost," Washington Post, 2/2; Cornwell, Reuters, 2/2; Rappleye, Becker's Hospital Review, 2/2; Sullivan, The Hill, 2/1; Greenwood, The Hill, 2/2; Sullivan, The Hill, 2/2; Edney et al., Bloomberg, 2/1).

Navigating the first 100 days of the Trump administration

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Since Donald Trump won the presidential election in November, health care reform has since quickly risen to the top of the GOP's policy agenda—and heath care executives are grappling with a new sense of uncertainty.

While many unknowns will remain across the next few months and potentially even years, the first 100 days of the Trump administration will provide significant insight into the direction of reform efforts. Read our briefing to learn what five key issues you should watch.

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