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Senate, House take first step toward repealing ACA

Publish date: January 12, 2017
By
Gregory Twachtman

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Comment by Dr. Michael Nelson

Dr. Michael E. Nelson, FCCP

Michael E. Nelson, MD, FCCP, comments: Independent of whether one has a favorable opinion of the Affordable Care Act (ACA), as a health care provider one must favor providing some medical care to all. The Congressional Budget Office has estimated that approximately 18 million people will lose their health care insurance if the ACA is repealed. Certainly, the uncertainty generated by the absence of an alternative plan, despite the promises, has kept everyone associated with the health care system uneasy about the future. Now imagine if one were a patient without health care insurance. I would like to remind all of our politicians of the words of our 35th president, John Kennedy, “Let us not seek the Republican answer or the Democratic answer, but the right answer. Let us not seek to fix the blame for the past. Let us accept our own responsibility for the future.” I hope they are listening.


 

With a Jan. 12 early morning procedural passed on party lines, the Senate has set the stage for the repeal of the revenue aspects of the Affordable Care Act. The House of Representatives passed similar legislation Jan. 13.*

Republicans will be using the budget reconciliation process, which will allow them to move forward with repealing certain provisions of the health care reform law without any Democratic support, although passage of any replacement will require some bipartisan support as Republicans do not have the required 60 votes to guarantee passage in the Senate.

The budget resolutions contain no details about what could be repealed or whether there will be a replacement, but it does direct the key committees to write draft legislation by Jan. 27.

Sen. Lamar Alexander (R-Tenn.)

Sen. Lamar Alexander (R-Tenn.)

However, in a floor speech Jan. 11, Sen. Lamar Alexander (R-Tenn.), chairman of the U.S. Senate Committee on Health, Education, Labor, and Pensions, offered some nuggets on how repeal-and-replace would proceed.

Senate Republicans “plan to rescue those trapped in a failing system, to replace that system with a functional market, or markets, and then repeal Obamacare for good,” he said.

Sen. Alexander said the process will come in three parts. The first will protect the 11 million people who have purchased health insurance through the exchanges so that they don’t lose coverage.

“Second, we will build better systems providing Americans with more choices that cost less,” he said. “Note I say systems, not one system. If anyone is expecting [Senate Majority Leader Mitch] McConnell [R-Ky.] to roll a wheelbarrow on the Senate floor with a comprehensive Republican health care plan, they’re going to be waiting a long time because we don’t believe in that. We don’t want to replace a failed Obamacare federal system with another failed federal system.”

The last part will be to repeal what remains of the law after the new plan is in place.

Sen. Alexander reiterated that any future bill will keep the ban on coverage denials for preexisting conditions and the allowance of coverage of children up to the age of 26 who are on their parents’ plans.

He stated that this reform effort will not address Medicare reform, which will be the subject of separate legislative action.

*This story was updated Jan. 13 at 4:30 pm.

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