Senate Unveils Updated Budget Reconciliation Bill To Dismantle ACA

December 1, 2015

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Source: California Healthline

On Monday, Senate Majority Leader Mitch McConnell (R-Ky.) unveiled an updated plan to dismantle the Affordable Care Act through the budget reconciliation process, Politico reports (Everett/Haberkorn, Politico, 11/30).

Background

The reconciliation process allows legislation to advance through the Senate on a simple majority vote. The process can be used to target aspects of the ACA that address spending and revenue, meaning the technique could not uproot the entire law. However, such an effort could render the law “unworkable.”

The House in October voted 240-189 to approve HR 3762, which would repeal the law’s:

  • “Cadillac” and medical device taxes; and
  • Individual and employer mandates.

In addition, the measure would strip federal funding from Planned Parenthood for one year and redirect some of the funding to community health care centers.

According to the Congressional Budget Office, the legislation would reduce federal spending by $79 billion over 10 years (California Healthline, 11/20).

Senate Unveils Bolstered Reconciliation Measure

The Senate’s proposal makes some changes to the House bill, but it still would repeal the law’s “Cadillac” and medical device taxes and block federal funding for Planned Parenthood.  The updated measure goes further than the House version by eliminating the fines that can be levied on U.S. residents and businesses for not purchasing or offering health coverage under the law.

The bill also would:

  • Eliminate the ACA’s subsidies to help consumers purchase health plans through the exchange created under the law (Politico, 11/30); and
  • Phase out the ACA’s Medicaid expansion after a two-year transition period.

According to The Hill, the provision to phase out the law’s Medicaid expansion will be considered as an amendment to the bill (Bolton, The Hill, 11/30). According to the Washington Post‘s “PowerPost,”an unlimited number of back-to-back amendments can be added to reconciliation bills, which could help to draw support for the measure from lawmakers who want to fully repeal the ACA (Snell, “PowerPost,” Washington Post, 11/30).

GOP senators said they expect to vote Wednesday on a motion that would initiate 20 hours of debate on the reconciliation measure. The senators then plan to vote on several amendments to the bill and final passage of the measure on Thursday (Bolton, The Hill, 11/30).

According to Politico, if the Senate approves the updated reconciliation bill, the House will then have to vote on the measure before it could be sent to President Obama. Obama is likely to veto the bill should it reach his desk (Politico, 11/30).

Government Shutdown Unlikely

In related news, House Majority Leader Kevin McCarthy (R-Calif.) on Monday said debate over whether the federal government should provide funding to Planned Parenthood is unlikely to force a federal government shutdown, The Hill reports.

McCarthy said he expects Congress to pass an omnibus spending bill by Dec. 11 to avert a federal government shutdown (Wong, The Hill, 11/30). He added, “I do not hear people shutting the government down over it right now, so that’s the bottom line.”

The comments came days after a shooting at a Planned Parenthood clinic in Colorado. Some Democrats have blamed Republicans for creating a hostile environment that in part could have fostered the attack.

According to the New York Times, McCarthy’s comments signaled recognition that renewed debate over Planned Parenthood funding would be controversial in light of the shooting (Herszenhorn, New York Times, 11/30).

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