Some people are calling efforts to repeal and replace the Affordable Care Act (ACA) dead after a shocking turn of events in which three Republican Senators voted against a bill that would have repealed some, but not all, of the ACA. While efforts to repeal and replace the ACA have stalled for the moment, it would be premature to call them dead.
Senate Majority Leader Mitch McConnell (R-KY) conceded that it was time to move on. That was very similar to comments made by Speaker of the House Paul Ryan after initial repeal and replace efforts failed in the House in March. By May, House Republicans had crafted a compromise that passed the House.
Initially, President Trump tweeted that they should let ObamaCare implode, but more recently he has said that repeal and replace should be the Senate’s top priority. A number of Senators and Congressional representatives have also called for continued repeal efforts.
If the President is serious about letting ObamaCare implode, he can hasten the process by refusing to continue cost sharing reductions. These are payments made by the federal government to insurance companies offering policies on the exchanges that have lower deductibles and copayments for people earning less than 250% of the federal poverty level. If the government discontinues these payments, there will be immediate, significant disruption to the individual health insurance market.
Senator McConnell suggested that working with Democrats on some kind of reform in the future is not out of the realm of possibility.
The health reform road ahead is unclear at this point. It is quite possible that smaller, more targeted fixes to the ACA will be attached to must-pass legislation such as appropriations bills or a debt ceiling bill. Stay tuned– developments in Washington will continue to be interesting.