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Timeline of ACA repeal and replace efforts

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115th Congress, 2017-2018
Healthcare policy
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For more on healthcare policy, view the following articles:
•Healthcare overview
•Graham-Cassidy Obamacare replacement plan
•Republican effort to repeal the ACA, July 2017
•Better Care Reconciliation Act of 2017 (Senate bill)
•115th Congress on the Better Care Reconciliation Act of 2017
•Republican senators on the BCRA
•American Health Care Act of 2017 (House bill)
•House's second attempt to pass the AHCA, April - May
•House's initial attempt to pass the AHCA, March
•House roll call vote on the AHCA
•Republicans who were likely to vote against the AHCA, March
•Timeline of ACA repeal and replace efforts
•Federal policy on healthcare, 2017-2020

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The Patient Protection and Affordable Care Act, also known as the Affordable Care Act (ACA) or Obamacare, was passed by Congress along party lines on March 21, 2010, and signed into law by President Barack Obama (D) on March 23, 2010. The Senate passed the ACA by a vote of 60-39 with no Republican support on December 24, 2009. The House passed the bill by a vote of 219-212 on March 21, 2010. Thirty-four House Democrats voted against the bill with all House Republicans.[1][2][3]

What is the ACA or Obamacare? The Patient Protection and Affordable Care Act, commonly known as the Affordable Care Act (ACA) or Obamacare, was signed into law by President Barack Obama (D) on March 23, 2010. The aim of the law was to provide health insurance coverage to more Americans, primarily through individual health insurance marketplaces and an expansion of the Medicaid program. Click here to read more about the healthcare law.[4][5]

Since the bill became law, Republicans have been trying to repeal and replace the ACA. In 2016, with control of the Senate and House, Republicans passed the Restoring Americans' Healthcare Freedom Reconciliation Act of 2015. The bill would have repealed several parts of the ACA, but it was vetoed by President Barack Obama on January 8, 2016. Sen. Susan Collins (R-Maine) and Sen. Mark Kirk (R-Ill.) were the only Republicans who voted against the bill.[6][7]

In 2016, Republicans and President Donald Trump (R) campaigned on repealing and replacing the ACA. After winning control of the presidency, Senate, and House, in the 2016 elections, Republicans have attempted on multiple occasions to repeal and replace the ACA, but, as of September 27, 2017, they had been unsuccessful. Below is a timeline of the 2017 efforts to repeal and replace the ACA.

2017: Timeline of ACA repeal and replace efforts

  • September 26, 2017: Sen. Bill Cassidy (R-La.) said that there would not be a vote on the Graham-Cassidy bill. He said, "We don't have the votes. We made the decision since we don't have the votes, we're going to postpone it." Republicans Sens. Susan Collins (R-Maine), Rand Paul (R-Ky.), and John McCain (R-Ariz.) all said they would vote against the bill, which would have caused the bill to fail. Sen. Lindsey Graham (R-S.C.) said that he and Cassidy would continue to push for a vote on the bill after Congress addressed a tax reform package, saying, "We're going to take our show on the road."[8]
  • July 28, 2017: The Senate voted on an amendment from Senate Majority Leader Mitch McConnell (R-Ky.), also referred to as the "skinny bill." The amendment contained the provisions to repeal the requirements for individuals to enroll in health insurance and for employers to offer it, among other provisions. The amendment was rejected by a 49-51 vote. Sens. Susan Collins (R-Maine), John McCain (R-Ariz.), Lisa Murkowski (R-Alaska) joined 48 Democrats in voting against the amendment.[10][11]
  • July 25, 2017: The Senate held a vote on a motion to proceed to the American Health Care Act of 2017 (AHCA), the House-passed repeal and replace bill. The motion was approved 51-50. Republican Sens. Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine) and all Senate Democrats voted against the motion. Vice President Mike Pence voted in favor of the bill to break the 50-50 tie. Sen. John McCain (R-Ariz.), who was diagnosed with brain cancer the previous week, returned to Capitol Hill to cast a vote in favor of the motion. Without his vote, the motion would have failed.[14]
  • July 21, 2017: The Senate parliamentarian ruled that the provision suspending funding for Planned Parenthood for one year in the revised BCRA did not meet the rules of reconciliation. She also ruled that the provision prohibiting the use of tax credits for plans that cover abortions in circumstances other than rape or incest or to save the life of the mother did not meet the requirements.[15]
  • July 20, 2017: The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) released a report estimating the cost of the revised version of the Better Care Reconciliation Act (BCRA). Key findings can be viewed here.[16]
  • July 19, 2017: After meeting with Trump in the White House, Senate leadership attempted to revive the BCRA or a version of it.[17]
  • July 17, 2017: Senate Majority Leader Mitch McConnell (R-Ky.) said that his party was unable to agree on a final version of the BCRA and would instead vote on a bill to repeal, but not replace, the ACA.[18][19]
  • July 15, 2017: Senate Majority Leader Mitch McConnell (R-Ky.) said that the Senate would not vote on the BCRA until after Senator John McCain (R-Ariz.) recovered from his eye surgery. McCain was recovering at his home in Arizona.[20]
  • July 11, 2017: Following a briefing with GOP senators, Senate Majority Leader Mitch McConnell (R-Ky.) delayed the start of the Senate's August recess to the third week in August in order to complete work on the BCRA and other items on the legislative agenda.[21]
  • June 27, 2017: Senate Republican leaders postponed a vote on the BCRA until after the July 4 recess.[22]
  • June 26, 2017: The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) released a report estimating the cost of the Better Care Reconciliation Act (BCRA) and its impact on the number of uninsured. Key findings can be viewed here.[23]
  • June 6, 2017: The Senate Budget Committee announced that the AHCA complied with the Senate reconciliation process. House Republicans were waiting for the committee's verdict on the AHCA before sending it to the upper chamber.[24]
  • May 24, 2017: The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) released a report estimating the cost of the AHCA as amended and its impact on the number of uninsured. The AHCA would reduce the federal deficit by $119 billion between 2017 and 2026 due to a $1.1 trillion decrease in direct spending and a $992 billion reduction in revenues. Compared to the ACA, 14 million more people would be uninsured in 2018 under the AHCA, and 23 million more people would be uninsured in 2026. In total, under the AHCA, 51 million people would be uninsured in 2026, compared to 28 million who would be uninsured under the ACA.[25]
  • May 4, 2017: The House passed the AHCA by a vote of 217-213.[26]
  • May 3, 2017: House Majority Leader Kevin McCarthy (R-Calif.) said that the House would hold a vote on the revised version of the AHCA on May 4, 2017. He wrote in a tweet, "Doing nothing is not an option. The American people are tied to #Obamacare’s sinking ship, and we have to act now. #AHCA."[27]
  • May 2, 2017: The House voted to approve waiving a rule requiring lawmakers to wait at least one day before voting on the AHCA. It would allow leaders in the House GOP to hold a vote on the AHCA as soon as they secured enough votes for passage.[28]
  • April 27, 2017: House Majority Leader Kevin McCarthy (R-Calif.) said that the House would not vote on the revised version of the AHCA before President Donald Trump 100th day in office.[29]
  • April 26, 2017: The House Freedom Caucus said that they would support the AHCA because of an amendment that would allow states to opt out of some provisions of the ACA.[30]
  • April 13, 2017: House Republicans added an amendment to the AHCA in an attempt to unite the party behind the bill. Rep. Tom MacArthur (R-N.J.), co-chair of the Tuesday Group, and Rep. Mark Meadows (R-N.C.), head of the House Freedom Caucus, introduced an amendment that proposed retaining the 10 essential health benefits as the federal standard for what health plans must cover, but would allow states to acquire a waiver from the requirement. Other provisions in the ACA that would be retained by the amendment included the prohibition on denying coverage for pre-existing conditions, the requirement to cover individuals on their parents' health plan until age 26, and limits on how much insurers may vary premiums for reasons such as age, gender, and health status (known as community rating). In addition to waiving the essential benefits standard, the amendment would allow states to obtain waivers from the community rating provisions, except for the rules limiting premium variance based on gender and age. States could only waive the limits on varying premiums based on health status if they had also established a publicly funded high-risk pool to cover individuals with costly conditions.[31][32][33]
  • April 3, 2017: White House officials discussed changes to the AHCA with the House Freedom Caucus. Officials proposed allowing "states to choose to apply for waivers to repeal two ObamaCare regulations that conservatives argue are driving up premiums. Those two regulations detail ObamaCare's essential health benefits, which mandate which health services insurers must cover, and 'community rating,' which prevents insurers from charging sick people higher premiums," according to The Hill.[34]
  • Rep. Mark Meadows (R-N.C.) said that the proposed changes would result in enough votes from Freedom Caucus members to pass the bill, but he said that he wanted to see the full text of the legislation before making a final decision.[34]
  • March 24, 2017: The House was expected to vote on the AHCA, but House Republican leaders withdrew the AHCA from consideration amid dwindling support.[35]
  • March 24, 2017: The House Rules Committee approved an amendment to the AHCA that would have repealed the ACA's requirement that insurers provide federally determined essential health benefits. Under the amendment, each state instead would have been required to determine which essential benefits insurers licensed in that state must cover. The amendment also would have provided $15 billion to states to promote access to preventive care, dental care, and vision care, and to provide maternity and newborn care and mental health services. The $15 billion would have been funded by maintaining a 0.09 percent Medicare tax on high-income earners for six years.[36][37][38]
  • March 23, 2017: The House was expected to vote on the AHCA, but the vote was canceled.[35]
  • March 20, 2017: The House added an amendment to the AHCA that provided for extra funding for tax credits for older Americans to help them pay their premiums and instructed the Senate to design the tax credits. It removed a provision in the original bill that would have allowed individuals to deposit leftover tax credit money into a health savings account. The amendment would have allowed states to establish work requirements for their Medicaid programs and would have allowed states to receive federal Medicaid funding in the form of a per-member amount or block grants, whichever they chose. The amendment would have repealed many of the ACA's taxes and fees and would have delayed the 40 percent excise tax on employer-sponsored plans until 2026. Finally, the amendment contained a provision specific to New York state: it would have prohibited New York from receiving federal reimbursement for Medicaid payments that counties make to the state in an attempt to shift more Medicaid spending to the state level.[39]
  • March 6, 2017: Representatives Kevin Brady (R-Texas) and Greg Walden (R-Ore.) introduced the American Health Care Act of 2017, a reconciliation bill to modify the budgetary and fiscal provisions of the ACA. It did not propose completely repealing the ACA.[43]
  • January 23, 2017: Sens. Bill Cassidy (R-La.) and Susan Collins (R-Maine) introduced S 191—the Patient Freedom Act of 2017. The legislation proposed replacing the ACA.[44][45]
  • Cassidy discussed the bill, saying, "I would say what we’re doing is moving the locus of repeal to state governments. On the one hand, that is philosophically consistent with where Republicans are. States should have the right to choose. It is also consistent with our long-stated [principle], ‘If you like your insurance, you can keep it.’"[46]
  • January 12, 2017: The Senate passed S Con Res 3, a budget resolution to begin rolling back the ACA, by a vote of 51-48. Sen. Rand Paul (R-Ky.) was the only Republican who voted against the budget resolution because he said that it increased the federal debt. Paul added, “I won’t vote for a terrible budget just to repeal Obamacare. … If I have to weigh the two problems, I actually think the debt is a more important problem than Obamacare.”[48][49]
  • January 4, 2017: The Senate passed S Con Res 3, a motion to begin debating a budget bill, by a vote of 51-48. The budget resolution proposed repealing parts of the ACA that related to the budget and taxes. The final legislation was expected to eliminate provisions that provided tax credits for low-income individuals to obtain health coverage, required all individuals to obtain coverage, and required employers to provide coverage to their employees.[50][51]

Recent News

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Timeline of ACA repeal and replace efforts - Google News

See also

External links

Footnotes

  1. ↑ New York Times, "Obama Signs Health Care Overhaul Bill, With a Flourish," March 23, 2010
  2. ↑ GovTrack, "H.R. 3590 (111th): Patient Protection and Affordable Care Act," December 24, 2009
  3. ↑ GovTrack, "H.R. 3590 (111th): Patient Protection and Affordable Care Act," March 21, 2010
  4. ↑ Kaiser Family Foundation, "Summary of the Affordable Care Act," April 25, 2013
  5. ↑ Encyclopaedia Britannica, "Patient Protection and Affordable Care Act (PPACA)," June 26, 2015
  6. ↑ Senate.gov, "On Passage of the Bill (H.R. 3762 As Amended)," December 3, 2015
  7. ↑ The Hill, "House passes ObamaCare repeal, sending measure to president," January 6, 2016
  8. ↑ The Hill, "Senate won't vote on ObamaCare repeal bill," September 26, 2017
  9. ↑ Politico, "McConnell spokeswoman: Senate to vote next week on Graham-Cassidy," September 20, 2017
  10. ↑ Senate.gov, "On the Amendment (McConnell Amdt. No. 667 )," July 28, 2017
  11. ↑ Axios, "Here’s the Senate’s “skinny” health care bill," July 27, 2017
  12. ↑ Senate.gov, "On the Amendment (Paul Amdt. No. 271 )," July 26, 2017
  13. ↑ Senate.gov, "On the Motion (Motion to Waive All Applicable Budgetary Discipline Re: Amdt. No. 270)," July 25, 2017
  14. ↑ Senate.gov, "On the Motion to Proceed (Motion to Proceed to H.R. 1628)," July 25, 2017
  15. ↑ CNN, "Senate parliamentarian: Anti-abortion provisions in GOP health care bill violate budget rules," July 21, 2017
  16. ↑ Congressional Budget Office, "H.R. 1628, the Better Care Reconciliation Act of 2017: An Amendment in the Nature of a Substitute," July 20, 2017
  17. ↑ Politico, "Key Senate Republicans to meet and try to revive health bill," July 19, 2017
  18. ↑ CNBC.com, "McConnell says GOP doesn't have votes to replace Obamacare, but will vote on repeal in 'very near future,'" July 18, 2017
  19. ↑ CNBC, "GOP's Obamacare repeal-only push quickly collapses," July 18, 2017
  20. ↑ The Washington Post, "McConnell defers vote on Senate health-care bill as McCain recovers from surgery," July 16, 2017
  21. ↑ CNN, "McConnell delays start of recess until third week in August," July 11, 2017
  22. ↑ The Wall Street Journal, "Short on Backers, GOP Delays Vote on Health Bill," June 27, 2017
  23. ↑ Congressional Budget Office, "Congressional Budget Office Cost Estimate: Better Care Reconciliation Act of 2017," June 26, 2017
  24. ↑ The Hill, "Budget Committee: House healthcare bill can move to Senate," June 6, 2017
  25. ↑ Congressional Budget Office, "Congressional Budget Office Cost Estimate: American Health Care Act of 2017," May 24, 2017
  26. ↑ Clerk.House.gov, "Final Vote Results For Roll Call 256," May 4, 2017
  27. ↑ Twitter, "Kevin McCarthy," May 3, 2017
  28. ↑ The Hill, "House GOP paves way for fast-tracking potential healthcare vote," May 2, 2017
  29. ↑ The Hill, "Republicans won't vote on ObamaCare replacement bill this week," April 27, 2017
  30. ↑ The Hill, "Freedom Caucus endorses revised ObamaCare repeal-and-replace bill," April 26, 2017
  31. ↑ NPR, "MacArthur Amendment to the American Health Care Act," April 13, 2017
  32. ↑ National Association of Insurance Commissioners, "Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges," April 20, 2010
  33. ↑ Politico, "White House plans Obamacare showdown next week," April 20, 2017
  34. ↑ 34.0 34.1 The Hill, "Pence presents new healthcare offer to Freedom Caucus," accessed April 4, 2017
  35. ↑ 35.0 35.1 The Hill, "House cancels ObamaCare repeal vote as GOP defections mount," accessed March 24, 2017
  36. ↑ The Hill, "Live coverage: Trump, GOP scramble for ObamaCare votes," March 24, 2017
  37. ↑ Washington Post, "This is why Obamacare is canceling some people's insurance plans," October 29, 2013
  38. ↑ U.S. House of Representatives, "Policy Amendment to the Manager's Amendment (Policy Changes) to H.R. 1628," accessed March 24, 2017
  39. ↑ Politico, "GOP leaders pile on sweeteners to sell Obamacare repeal," March 20, 2017
  40. ↑ The Hill, "Budget panel advances ObamaCare bill with three GOP defections," accessed March 16, 2017
  41. ↑ EnergyCommerce.House.gov, "Energy and Commerce Committee Advances Legislation to Repeal and Replace Obamacare," accessed March 9, 2017
  42. ↑ WaysandMeans.gov, "Ways and Means Republicans Take Historic Action to Repeal Obamacare & Ensure More Americans Have Access to Affordable Care," accessed March 9, 2017
  43. ↑ House Energy and Commerce Committee, "Budget Reconciliation Legislative Recommendations Relating to Repeal and Replace of the Patient Protection and Affordable Care Act," accessed March 7, 2017
  44. ↑ Congress.gov, "S.191 - Patient Freedom Act of 2017," accessed March 13, 2017
  45. ↑ Collins.Senate.gov, "Cassidy, Collins Release Legislative Text for Obamacare Replacement Plan," accessed March 13, 2017
  46. ↑ The Wall Street Journal, "GOP Senators Propose Health Law Replacement That Lets States Opt Out," accessed March 13, 2017
  47. ↑ Clerk.House.gov, "Final Vote Results for Roll Call 59," accessed January 13, 2017
  48. ↑ Senate.gov, "On the Concurrent Resolution (S. Con. Res. 3)," accessed January 13, 2017
  49. ↑ USA Today, "Sen. Rand Paul using Obamacare repeal to protest debt," accessed January 13, 2017
  50. ↑ Congress.gov, "S.Con.Res.3," accessed January 6, 2017
  51. ↑ Senate.gov, "On the Motion to Proceed (Motion to Proceed to S. Con. Res. 3)," accessed January 6, 2017
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