As this issue of News Now
is being written, the US Senate continues to debate possible changes to the Affordable Care Act (ACA). It’s expected that Republicans will bring forward a proposal to repeal a limited number of elements of the ACA, including the mandate that individuals purchase insurance, the tax on medical devices, and the requirement that large employers offer health insurance coverage or else pay a fine. Passage of this “skinny repeal,” proponents argue, would allow the Senate to continue negotiations in a conference committee of Senate and House members. An initial analysis of the proposal suggests that the number of Americans without insurance coverage would increase by 16 million and individual market premiums would increase by about 20 percent. Because actual bill language is being closely held, that analysis may change. It’s unclear whether this approach will garner the required 50 votes for passage or if it will pass the muster of the Senate’s parliamentary rules.
Senate action began on Tuesday as members took up a motion to begin debate on repealing or modifying the ACA. With two GOP Senators voting against the motion, the 50-50 tie was broken by Vice President Pence and included the dramatic return of Sen. John McCain (R-AZ) from recent surgery and a brain cancer diagnosis. Since Tuesday, the Senate has rejected a proposal to repeal the ACA in its entirety without a replacement plan, as well as the Senate’s original replacement proposal, known as the Better Care Reconciliation Act.