The Affordable Care Act Survives Republican Repeal and Replace Attempts

For those of us who stayed up late to watch the final vote on the "skinny" Repeal and Replace, there was drama until the end. Senator McCain, having voted for the two earlier Repeal and Replace plans, voted against the minimalist "skinny" repeal bill, ending the Senate's attempts to sink the ACA before the August recess. He joined Senators Collins (R-ME) and Murkowski (R-AK) who steadfastly voted against all three plans despite huge pressure from their Republican colleagues and the Administration.

The President continues to call for further Repeal votes so the Republicans can fulfill their seven year pledge to dismantle the ACA. McConnell and other Senate Republicans seem to have little appetite to continue with healthcare as their primary legislative focus in coming weeks.

Republicans Focus on "Skinny" Repeal Now

Having failed to get 50 votes on either full repeal or on repeal and replace, Republicans are now focusing on "skinny repeal." Senators are not sure exactly what will be in the proposal, but it is expected to include a withdrawal of the individual mandate, tax penalty and medical devices tax. This initiative is gathering steam, with Heller and Rand both expressing support.

It would not cut Medicaid funding, but Blue Cross Blue Shield warned that premiums on the individual market would skyrocket without it. The self-employed would be among those hardest hit, especially those with chronic conditions who buy more comprehensive (and expensive) policies.

If it passes the Senate, it would then head to the House where it may be voted on as early as Saturday.

The bronze and silver policy offerings on the individual markets have been challenging for many consumers who balk at paying substantial premiums for high deductible policies. It is most frustrating for those who do not qualify for subsidies. They are paying thousands of dollars annually per family member without receiving much actual healthcare.

Click here for article from The Hill.

Republicans Just Voted to Proceed on Bill to Repeal ACA

VP Mike Pence cast the deciding vote to move forward out of regular order to repeal and/or replace the ACA. NYTimes article.

Senate Republicans Meet Late into the Night; No Breakthrough, but Some Optimism

President Trump is still insisting that the Senate Republican get an ACA repeal bill to him as soon as possible. McConnell is still planning to have a vote on such a bill next week. Senate Republicans are expressing optimism publicly, but are privately skeptical. The latest wrinkle is that Senator McCain has a brain tumor and there is no set date for his return to the Senate. Bipartisanship is not an option according to Republican party leadership. Meanwhile, millions of Americans are unsure what access they will have to health coverage and at what cost. The exchanges are set to go live with the 2018 policies and pricing in less than 3 months. Read the Politico article here.

Even Health Insurers Oppose the Cruz Amendment

In an unusual move, health insurers have weighed in on the current Senate repeal and replace bill. They state that the Cruz Amendment, which would allow states to waive the 10 essential benefits coverage required under the ACA, would encourage healthy people to buy cheap policies and result in exorbitant premiums for people who would need the more comprehensive coverage. Without the individual mandate or the more comprehensive (and expensive policies), insurance companies would have less money to cover the expenses of the sickest patients.

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