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Update (7/26 at 5 p.m.): Senate Rejects Repeal-only Health Care Reform Legislation
Following the narrow passage of a procedural vote, the U.S. Senate has formally begun consideration of legislative proposals to repeal and replace the Affordable Care Act (ACA). In response, ASA has again submitted formal comments for Senate consideration as they continue to debate health system reforms. In the letter, ASA encourages the Senate “to adopt provisions that expand access to insurance coverage” and commends the Senate for maintaining a robust employer-sponsored insurance system. However, the letter also references serious reservations about provisions that would increase the number of uninsured and waiver provisions that would allow states to opt out of the ten Essential Health Benefits established under the ACA.
Last night, after several weeks of internal discussions, the Senate narrowly passed a procedural vote to begin debate on health care reform legislation. The vote passed 51-50 with Vice President Mike Pence casting the tie-breaking vote. All Democrats voted against that procedural move, as did two Republicans – Senator Susan Collins (R-ME) and Senator Lisa Murkowski (R-AK).
Later that evening, Senators cast their first vote on one of the legislative proposals, the Better Care Reconciliation Act (BCRA), which would repeal and replace the Affordable Care Act. This bill included an amendment from Senator Ted Cruz (R-TX), that would provide for the sale of insurance plans that are less expensive and provide less coverage than required under the ACA, as well as an amendment by Senator Rob Portman (R-OH) that would add $100 billion in additional funding to a state stability fund to help low-income individuals transition from Medicaid and pay for private insurance premiums and co-pays. Because this proposal was not the subject of a Congressional Budget Office (CBO) analysis – a requirement under Senate reconciliation rules – the proposal required 60 votes to pass. In the end, the proposal failed to receive even 51 votes as nine Republicans - Senators Collins (ME), Corker (TN), Cotton (AR), Graham (SC), Heller (NV), Lee (UT), Moran (KS), Murkowski (AK), and Paul (KY) - joined all Senate Democrats in opposing the bill, causing it to fail, 43-57.
Today, a vote is expected on a repeal-only proposal, which has also faced opposition from some Senate Republicans. Additional votes are also expected on several other proposals, including a “skinny,” or scaled down version of BCRA which may include repeal of the individual and employer mandates, and some of the tax provisions which fund the ACA. It is also expected that the Senate will consider a number of Republican and Democratic amendments.
ASA physician leaders and staff will continue to carefully monitor the Senate’s legislative process.
Read a copy of ASA’s letter here.
Find more information about health care reform proposals here.
