As everyone knows by now, Senate Republican leaders Monday night abandoned their effort to pass the Better Care Reconciliation Act (BCRA), their bill to repeal and replace parts of the Affordable Care Act (ACA). With a total of four Republicans announcing they would vote against the measure, it would have resulted in certain defeat on the Senate floor.
However, Monday’s action does not mean the end of the health care debate in Congress. Majority Leader Mitch McConnell has vowed to try to pass a bill that first passed in 2015 and was vetoed by President Obama that would simply repeal the ACA, effective in two years. Congress would use the intervening two years to develop a replacement. However, that effort also appears to be doomed, as three Republican Senators on Tuesday announced they would vote against such a measure.
Lawmakers also could begin a separate effort to restructure the Medicaid program along the lines included in the BCRA, and any tax reform bill is likely to address at least some of the tax provisions in the ACA that helped offset the cost of expanded coverage.
From the White House, President Trump on Tuesday said his plan is to “let Obamacare fail” and then try to craft a replacement.
The most immediate concern about the ACA is the stability of the insurance markets. There appears to be bipartisan support for funding the subsidies insurers use to help defray deductibles and co-payments for low-income people. Failure to take this action is likely to substantially increase insurance premiums in 2018.
It is certainly possible that Republican Senators will try to resurrect their repeal-and-replace plan sometime in the future. WSHA will remain vigilant in the weeks and months ahead to be prepared for whatever comes next.
Early in this debate, the WSHA Board made clear that our top policy priority is access to high-quality care. If the ACA is to be repealed, whatever follows must cover at least as many Washingtonians as are currently covered. Going forward WSHA will advocate for policies that strengthen the insurance market, expand coverage and offer solutions that will improve the health care system. Working closely with the American Hospital Association (AHA), our approach to this discussion will continue to be non-partisan and data-driven.
Thank you for all your help during this arduous seven-month process. Your voice to our Congressional delegation was critically important to effectively delivering our message.
WSHA Senior Vice President for Advocacy and Government Affairs