Congress Takes First Step to Repeal Affordable Care Act

The House of Representatives passed a budget resolution, or budget framework, that many believe will be the first step in the repeal of the Affordable Care Act.  The Senate considered the measure first, passing it on Thursday following fifty hours of debate.  The legislation passed both bodies on party line votes, with nine Republicans voting against the budget resolution in the House on Friday.  The budget resolution includes specific reconciliation provisions that will allow Congress to move forward with repealing key portions of the Affordable Care Act.

Passage of the budget resolution allows Congress to move forward with a legislative procedure, “reconciliation,” which, by virtue of the simple majority vote required, is shielded from the Senate filibuster rule requiring sixty votes to end debate.  This will allow the Republican Majority in Congress to easily pass Affordable Care Act repeal legislation that relates to taxes and spending; namely the individual mandate, the employer mandate, subsidies, the Medicaid expansion provisions and similar revenue related provisions.  Congressional leaders have indicated that they plan to send a reconciliation bill to the President for his signature before the President’s Day recess.   

One of the issues the Republican majority is grappling with, among many other issues, is the transition period for repealing and replacing the Affordable Care Act (ACA).  Some have argued that the timeline should be no greater than 2 years before ACA is repealed and a replacement bill ultimately takes its place, while others have argued for 3 years or, perhaps, longer.  Many policymakers have indicated a desire to vote simultaneously on repeal and replacement measures.  While President-elect Donald Trump has vowed to act quickly on replacement package, this legislation will be subject to the Senate filibuster; meaning that nine Democratic votes will be needed for passage.  

The American Society of Anesthesiologists will continue to closely monitoring this process and all related legislation.