CSAC Bulletin Article

Federal Update: Senate Begins Process to Repeal ACA

January 12, 2017

Senate Takes First Step Toward ACA Repeal; Still A Long Way to Go

In the early hours of January 12th, the Senate took the first step toward repealing the Affordable Care Act (ACA).  By a narrow vote of 51 to 48, the upper chamber adopted a fiscal year 2017 budget resolution that instructs key House and Senate committees to begin work on legislation that would repeal major portions of the landmark health care law.  While the House is expected to approve the resolution on Friday, it is important to note that the budget measure is not signed by the president and does not have the force of law.  It simply sets in motion a subsequent budget reconciliation process.

While separate legislation will need to be developed to roll back the ACA, reconciliation procedures would allow Republican lawmakers to use special budget rules to expedite repeal efforts.  Under such a process, Senate Democrats will be unable filibuster a repeal bill, and Republicans will only need a simple majority for passage – rather than a 60-vote supermajority, which is typically required.  Notably, reconciliation can only be used in connection with provisions that have a direct budgetary impact.  This is sure to complicate the repeal effort, as certain aspects of the ACA, including the mandate that insurers cover individuals with pre-existing conditions, cannot be modified using the budget process.

Prior to passage of the resolution, Senate Democrats forced a marathon session of votes, known as a “vote-a-rama,” on amendments intended to put GOP lawmakers on record in opposition to popular aspects of the health-reform law.  None of the amendments were ultimately adopted, but the debate served as a preview of the battles that are likely to come.  While the final tally fell largely along party lines, one Republican – Senator Rand Paul of Kentucky – opposed the budget measure.  In doing so, Paul expressed concerns about rushing to repeal the ACA without an alternative in place.  It should be noted that California Senator Dianne Feinstein, who earlier in the day underwent a procedure to insert a pacemaker, was absent for the vote.

Looking ahead, President-elect Trump and congressional Republicans are hoping to move quickly.  While GOP leaders have not yet settled on a plan for replacing the ACA, Speaker Paul Ryan (R-WI) has endorsed a strategy that would simultaneously repeal and replace the law.  Under the current timetable, repeal legislation is expected to emerge by the end of January, with votes possible by the end of February.  It should be noted, however, that many observers are predicting that Republicans will need to modify their ambitious schedule due to the highly complex and controversial nature of the legislative task.

Other Issues

Aside from ACA repeal efforts, debate over the president-elect’s top cabinet picks dominated the news this week, with several of Mr. Trump’s nominees appearing before various Senate committees to undergo their required confirmation hearings.  While Congress cannot confirm the nominees until Trump is officially sworn in on January 20th, GOP leaders are trying to ensure that the president-elect will have as many of his cabinet secretaries in place as possible on his first day in office.  For their part, Democrats have been pressing Republican leaders to delay hearings or confirmation votes amid concerns that several of the nominees have not been fully vetted or have not submitted the necessary paperwork.

Across Capitol Hill, GOP House leaders have focused their attention in the early days of the new Congress on a series of bills aimed at limiting future regulations and rolling back many of the rules put in place by the Obama administration.  For example, one bill – the Regulations from the Executive in Need of Scrutiny (REINS) Act (HR 26) – would require both chambers of Congress to pass a resolution of approval before any new major regulation could take effect.  Another measure, entitled the Midnight Rules Act (HR 21), would allow Congress to repeal rules that are implemented in the final year of a president’s term.  Both pieces of legislation were cleared by the lower chamber on near party-line votes, a likely bellwether of the partisanship that is expected to characterize the new Congress.

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