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U.S. Senate Rejects ACA “Skinny Repeal” Legislation

July 28, 2017

Early this morning, the Senate voted 51 to 49 against the Health Care Freedom Act, also known as “skinny repeal” legislation. The legislation would have repealed limited portions of the Affordable Care Act (ACA), including the individual and employer mandates.
 
Senator John McCain (R- AZ) joined Senators Susan Collins (R- ME) and Lisa Murkowski (R-AK) and a unanimous Democrat caucus in voting against the bill.
 
The Congressional Budget Office issued an analysis indicating that the legislation would likely result in 16 million more Americans becoming uninsured by 2026. The reductions included less individuals being covered under Medicaid (7 million), through the individual market (6 million), and through employer-based coverage (2 million).
  
Congressional leaders have not indicated any clear next steps. Although the legislative options are much narrower, Congressional leadership is still under pressure to pursue avenues to repeal the ACA. Policies impacting Medicaid and Medicare could be considered in the context of producing budget savings.
 
Given the authority allowed the U.S. Secretary of Health and Human Services under the ACA, the Trump Administration may also pursue regulatory actions that could undermine, rather than stabilize, insurance products sold on the ACA’s Health Insurance Marketplace.
 
For example, the Administration could withhold payments to insurers that hold them harmless for the cost saving reduction subsidies that, under the ACA, are provided to low-income people and families who purchase their health insurance on the Marketplace.
 
HAP has consistently urged federal lawmakers to thoughtfully consider approaches to protect access to health insurance coverage and health care.
 
In a statement, Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania (HAP), reflected on the “difficulty of finding consensus on a plan that preserves access to health insurance coverage and health care,” thanked Senators who voted "no," and especially thanked the members of the Pennsylvania delegation whose votes helped protect coverage throughout Congress’s repeal and replacement deliberations.
 
Bipartisan efforts could emerge by building on collaborative work by governors or coalitions within Congress that are seeking consensus. Many members of the Pennsylvania Congressional delegation are involved in these bipartisan discussions and could be influential in the policy process moving forward.
 
In his statement, Carter pledged that HAP will continue to collaborate with lawmakers and federal agencies to improve upon the ACA and provide stability for patients and providers, saying “this is our charge as providers, practitioners, advocates, and consumers alike, and our work is never done.”
 
Please contact Laura Stevens Kent, vice president, federal advocacy, with any questions regarding federal activity surrounding the ACA.
 

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