The rollercoaster effort by Republicans to repeal and replace the Affordable Care Act (ACA) took yet another dramatic turn on Tuesday. The unexpected return of ailing Sen. John McCain combined with a tie-breaking vote from Vice President Mike Pence gave Senate GOP leaders the 51 votes necessary to begin debate on the future of the ACA. The Senate is expected to consider three main proposals:
- The Better Care Reconciliation Act that leaders have been crafting for weeks;
- Straight-up repeal of the ACA with no replacement; and
- A so called “skinny” reform that primarily removes a few unpopular portions of the ACA’s commercial insurance market reforms, such as the individual and employer mandates.
All proposals would be subject to an unlimited number of amendments submitted by senators. The BCRA was considered Tuesday and failed 43-57. The pure repeal amendment failed 45-55 on Wednesday. Additional amendments will be considered prior to a final vote which could come Thursday or Friday.
Should any bill be adopted by the Senate, it would need to return to the House for either an immediate vote as is or a more time-intensive conference process that attempts to reconcile differences between each chamber’s version of the legislation. The latter scenario would likely carry beyond the upcoming August congressional recess. WSHA will prepare and distribute bill analysis and member advocacy materials if and when the Senate takes action.
WSHA Senior Vice President of Advocacy and Government Affairs