Congress Approves Bill Repealing Much of the ACA

In what will ultimately amount to a symbolic message from Republicans, who have vowed to repeal the Affordable Care Act since becoming the majority party, a reconciliation bill repealing the health reform legislation passed the Senate by a vote of 52-47, a handful of Republicans voting against the measure and only one Democrat voting for it. The reconciliation process prevented a filibuster and allowed for passage of the legislation by a simple majority. The House had previously approved the legislation by a comfortable margin.

Specifically, the reconciliation measure would effectively repeal: 1) the individual and employer mandates; 2) Medicaid expansion; 3) the authority for the federal government to run health insurance exchanges; and 4) subsidies for plans purchased through the marketplace. In addition, the bill eliminated a number of the law's taxes. Controversially, the measure also defunds Planned Parenthood, a provision that caused moderate Republican members Susan Collins (R-Maine) and Mark Kirk (R-Ill.) to join a largely united Democratic caucus in voting against the package. An amendment to repeal the Cadillac tax, a 40% non-deductible excise tax on employer-sponsored health coverage that provides high-cost benefits slated to take effect in 2018, was introduced and received overwhelming bipartisan supported.

The Senate version of the bill expanded upon the House passed-measure. Several conservative Senators believed the House bill did not go far enough to repeal the ACA in its entirety, and they drove the process of amending the legislation. The amended legislation is now subject to approval by the House before being sent to the White House. The House adjourned for the calendar year without sending the reconciliation bill to the President, due to time-consuming negotiations on fiscal year (2016) omnibus funding and tax package. Waiting until 2016 will ensure that the President is forced to actively veto rather than pocket veto the bill. Typically, legislation that clears Congress becomes law without a presidential signature after 10 days, but it does not become law if Congress adjourns during that period. While President Obama is sure to veto the legislation, this will be the first time such repeal has succeeded in reaching his desk. According to the Congressional Budget Office (CBO), the reconciliation bill would reduce the deficit by $295.6 billion over the next decade.