CSAC Bulletin Article

ACA Repeal & Replacement Fails to Move in U.S. Senate

July 20, 2017

Senate Majority Leader Mitch McConnell’s (R-KY) effort to bring an Affordable Care Act (ACA) repeal and replacement bill to the floor collapsed this week in the face of opposition from several members of his own party.  The development marked a stunning setback – and a potentially fatal blow – for Republicans in their seven-year quest to overturn President Obama’s signature domestic achievement.  The continued legislative uncertainty also raises serious questions regarding the long-term future of the American healthcare system.

Shortly after McConnell’s admission that he lacked the votes to proceed to the legislation, President Trump took to Twitter to say that Republicans should simply repeal the ACA and work on a long-term plan – with Democrats – to replace Obamacare.  Incidentally, the majority leader endorsed the president’s recommendation in announcing his intention to bring up a bill to repeal the ACA in two years, with a subsequent measure drafted to address health coverage and access.  That effort, however, also appears doomed as three Republican senators – Shelley Moore Capito, (WV), Susan Collins (ME), and Lisa Murkowski (AK) – have all declared that they will oppose a procedural motion to begin debate on a repeal-only bill. 

Looking ahead, it remains uncertain whether Republicans will be able to jumpstart a renewed healthcare reform discussion.   In the continued absence of achieving critical mass within their own party ranks, Republicans would need to rely on Democrats to come to the table, perhaps to discuss improvements to the existing system, as was recently suggested by Senate Minority Leader Chuck Schumer (D-NY).

Another potential dynamic is President Trump’s ability to dictate significant changes in the operation of the current healthcare system.  For starters, the president has continually threatened to withhold billions of dollars in cost-sharing reduction payments, which are provided to insurance companies in exchange for reducing deductibles for low-income customers.  In response to the prospect of such a move, insurers have raised healthcare premiums for 2018 and may pull out of additional markets if the federal payments are ultimately eliminated.


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