While the U.S. House of Representatives passed legislation to finally “repeal and replace” the Affordable Care Act on Thursday, the story is far from over. (By the way, this bill actually doesn’t repeal anything.)
The measure got through the House with a 217-213 vote, as all voting Democrats and 20 mostly moderate Republican holdouts voted no.
The bill goes to the Senate, where legislators are already saying changes will be necessary – changes will mean that both houses will need to resolve differences before the bill heads to President Trump’s desk. The bill also will be “scored” by the Congressional Budget Office. Congress usually gets a budget estimate before it takes a vote. The House skipped that, but the Senate says it will not.
The budget score is particularly crucial on this bill in the Senate because it has to meet the requirements of the “reconciliation process.”
The New York Times provides some explanation of reconciliation rules:
One possible roadblock is the Senate parliamentarian. Republicans have pursued a procedural tool known as reconciliation in the hopes of passing the bill with a simple majority, rather than having to clear a 60-vote threshold with Democratic assistance. Reconciliation rules allow for changes on matters of taxes and spending but not broader policy changes. Some elements of the House bill had already threatened to draw the parliamentarian’s attention, and Democrats have strategized about specific components to target on these grounds.
And Sarah Ferris provides some important information in this AHCJ tip sheet, “How Congressional Republicans plan to gut the ACA.”
Here are some smart pieces to help us see what’s coming and some potential stories to follow:
- A Squeaker In The House Becomes Headache For The Senate: 5 Things To Watch, Kaiser Health News
- House Passes AHCA: How It Happened, What It Would Do, And Its Uncertain Senate Future, Timothy Jost on the Health Affairs blog
- “Senate consideration will be scheduled following the completion of procedural and budgetary scorekeeping reviews,” according to a statement from U.S. Senate Majority Leader Mitch McConnell (R-KY)
- The Next Step for the Republican Health Care Law: A Skeptical Senate, The New York Times
- In lieu of a CBO score, an overview of the expected effects of the GOP health-care bill, The Washington Post
- The GOP Health Bill Is Still Far From Law, FiveThirtyEight.com
- Senate GOP Plans Own Obamacare Repeal Bill After House Vote, Bloomberg
- GOP Health Bill Jeopardizes Out-of-Pocket Caps in Employer Plans, The Wall Street Journal
- These are all the people the Republican health care bill will hurt, Vox
- Think you’re not affected by the GOP health bill? Think again, Stat
- AHCJ tip sheet: How ACA repeal could impact mental health care
- Half of voters oppose allowing states to opt out of certain protections for people who have pre-existing health conditions, rejecting a key concession that House GOP leaders made to win over conservative hardliners on their health care bill: Morning Consult/Politico poll
- Penn’s Leonard Davis Institute of Health Economics has an ACA Impact Series that provides insight and analysis from prominent health economists about the ACA and policy decisions that legislators will have to make.
(Note: I will add to this list as I come across relevant coverage.)