Senate to Consider Budget Reconciliation that Would Start ACA Repeal Process

On January 2, the first day of the new Congressional session, Senate Budget Chairman Michael Enzi (R-WY) introduced a FY 2017 budget resolution that contains reconciliation instructions for two House and two Senate committees to write legislation repealing the Affordable Care Act (ACA). Budget reconciliation bills may only include provisions that have a significant budget impact, so the instructions are targeted to only relevant pieces of the health care law that are within the purview of the designated committees. In other words, repeal of the ACA in its entirety would have to come through a separate legislation action, but certain key portions could be repealed through budget reconciliation. 

Congressional Democrats have sharply criticized any efforts to repeal the ACA, saying the Republicans’ plans will “Make America Sick Again.” Democrats are organizing constituent rallies nationwide to show support for the law, saying that while there is room to improve the law, rolling back the ACA would result in disrupted service and loss of access to medical care for millions of Americans. The Democratic Governors Association (DGA) said in a December 21 letter to Republican Congressional leaders, “Repealing the Affordable Care Act, including its Medicaid expansion, would be a financial and health disaster for states. Repeal would throw millions of our residents off their health coverage, shift enormous costs to state governments – blowing a hole in state budgets – and cause economic uncertainty for our states’ businesses, hospitals, and patients.”

Some Republicans have said that a “repeal and delay” of the law is possible, passing legislation to repeal the law but then delay the effects for several months or years to allow time for a replacement plan to be crafted. Speaker of the House Paul Ryan (R-WI) said last week that the replacement plan will be ready within the year, a much more expedited timeline than the three years that has often been discussed. Ryan said that there are serious conversations and negotiations that must occur before he can detail what will be in the replacement plan. In preparation for the new Congressional session, last month leading House Republicans sent a letter (attached below) to state governors and state insurance commissioners asking for feedback on ways Congress should approach the country’s health care provision system.