Eager to prove that they can keep their campaign promises, GOP leaders are expected to make revocation of key ACA provisions a top priority when the 115th Congress convenes in early January. For instance, party leaders have expressed their intention to scrap the mandate requiring people to enrol in health coverage as soon as possible.
A bare-bones budget resolution serving as a vehicle to dismantle the Affordable Care Act (ACA) will get a House floor vote the week of 9 January, according to a memo from Rep. Greg Walden (R-Ore.), the incoming chairman of the House Energy and Commerce. As such, the Senate could take up and pass the budget resolution during the prior week.
Republican leaders are committed to repealing the ACA and plan to do so through an expedited budget reconciliation process that requires a simple majority vote in the Senate. That process would enable Republicans to strip funding for major parts of the healthcare law, such as the cost-sharing subsidies, Medicaid expansion and premium stabilisation programmes.
Budget reconciliation bills can only include provisions with a budgetary impact and that do not raise spending, hence there would likely be a delay — possibly by as much as three years — before Republicans implement a plan to replace the ACA.
Not a few healthcare industry leaders have warned of possible repercussions if a replacement plan is delayed. They are worried that this could cause the individual insurance market to collapse and endanger hospitals that would provide uncompensated care for the 20 million people who would become uninsured once the ACA is repealed.
Healthcare leaders would like the incoming administration under President-elect Donald Trump to put transition period policies in place to keep the individual market afloat in the meantime. For instance, industry lobbying group America's Health Insurance Plans has warned against repealing the cost-sharing subsidies. It is unclear whether the GOP leaders plan to retain any key ACA provisions.
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