ACA Repeal Process Begins In Congress

On January 3, 2017, Senator Mike Enzi, Chair of the Senate Budget Committee, introduced a concurrent budget resolution in the Senate to begin the process of repealing the Affordable Care Act. The resolution provides budget "reconciliation" instructions to the Senate Finance and Health, Education, Labor, and Pensions committees and the House Committees on Energy and Commerce and Ways and Means to submit their recommendations to the budget committees of the respective houses of Congress by January 27, 2017 for changes in the laws within their jurisdiction to reduce the deficit by no less than $1 billion for the years 2017 through 2026. This provision does not specifically refer to repeal of the Affordable Care Act (ACA), but that is clearly its goal.

The concurrent resolution also establishes a "reserve fund for health care legislation," which is intended to pocket any savings from repeal for subsequent replacement legislation, as well as a "deficit neutral reserve fund" to revise allocations within the budget resolution and adjustments to the pay-as-you-go ledger in the Senate to ensure that repeal legislation does not violate budget requirements. The reserve fund would allocate $2 billion of savings from the repeal toward reducing the deficit, but hold the rest for eventual replacement legislation. Finally, the resolution would provide that a point of order would not be available to object that repeal provisions would raise budget deficits in decades beyond 2026.

A budget resolution cannot be filibustered in the Senate and need only pass each house by a simple majority. It is likely that debate will be taken up on the legislation the week of January 9 after Congress organizes, if not sooner. Debate on a budget resolution in the Senate is limited to 50 hours, but beyond that time an unlimited number of amendments can still be offered without debate, the so-called vote-a-rama procedure.

Debate on the budget reconciliation legislation that will be introduced following review by the budget committees in late January or early February will be limited to 20 hours in the Senate. The budget reconciliation legislation is also permitted under Senate rules to include provisions that more than incidentally affect the revenues or outlays of the United States government. That legislation, also not subject to filibuster, is likely to repeal some provisions of the ACA immediately but to delay repeal on other provisions for some period of time while Congress tries to come up with a replacement plan.

from Health Affairs BlogHealth Affairs Blog http://ift.tt/2i7iOer