ACA Repeal and Replace Update

The U.S. Senate has begun debate on amendments to repeal all or sections of the Affordable Care Act (ACA), with two significant votes already taken. The first was a procedural vote yesterday afternoon on the motion to proceed to debate, which was cleared by a vote of 51 to 50, with Vice President Mike Pence serving as the tiebreaker. Sens. Lamar Alexander (R-TN) and Bob Corker (R-TN) voted with the majority to proceed to debate.

The House-passed American Health Care Act (AHCA), H.R. 1628, remains as the core bill under consideration. However, recognizing the House bill is unlikely to pass in its current form, Senate Republicans are seeking to amend H.R. 1628. This includes the recent proposal of the Better Care Reconciliation Act (BCRA), which was crafted by Senate Majority Leader Mitch McConnell (R-KY). The BCRA amendment was offered last night and was defeated by a vote of 43 to 57. Sen. Corker joined eight other Senate Republicans in opposing this proposal.

The BCRA amendment included reforming Medicaid to a per-capita cap program and the Consumer Freedom Amendment drafted by Sen. Ted Cruz (R-TX), which would have allowed additional health plan offerings that do not comply with marketplace requirements. As the Consumer Freedom Amendment was determined by the Senate parliamentarian to not pass the Byrd Rule (meaning the amendment is not germane to the budget), it required 60 votes to pass. THA strongly opposed the BCRA and Sen. Cruz’s amendment and know many of you also have voiced your opposition to these proposals, as well as the original House bill.

Earlier this morning, I contacted Sen. Corker’s office to express our appreciation for his no vote against the BCRA. The Senate plans to proceed with the consideration of dozens of amendments over the next few days. We expect one of these amendments to be a full repeal of the ACA and another to be a “skinny” bill, which will serve more as a place holder. The so-called “skinny” bill has not been released yet, but it has been described as a bare-bones bill limited to repealing the individual and employer mandate penalties, and the medical device tax. If this skinny bill is passed, possibly as a last recourse, it will allow the Senate to move to a conference committee with the House, where further efforts on the repeal of the ACA can continue.

THA will continue to urge Tennessee’s senators to defeat these repeal efforts and return to the committee process to focus on drafting individual insurance market stability measures.

It is extremely important to let our senators know the impact all the proposed legislation would have on your institution. Let them know that coordinating and holding open hearings so the Senate can hear from constituents on how best to replace or repair the ACA is critical. Finally, I ask that you reach out and thank Sen. Corker for voting against the BCRA. Contact information for both senators is below.

This continues to be a fluid and rapidly changing issue. THA will keep members informed of new developments and needed actions.

For more information, contact Craig Becker at 615-256-8240.