Congress Considers Repeal of the ACA through Reconciliation

The House and the Senate have been working all fall to repeal parts of the Affordable Care Act through the budget reconciliation process. Earlier this month, the House approved a measure that would partially repeal the Affordable Care Act (ACA) and defund Planned Parenthood for the coming year. The bill would also reduce the deficit by $130 billion over the next decade. In a vote of 240-189, Rep. Ken Buck (R-Col.), Rep. Bob Dold (R-Ill.), Rep. Richard Hanna (R-N.Y.), Rep. Walter Jones (R-N.C.), Rep. Mark Meadows (R-N.C.), and Rep. Matt Salmon (R-Ariz.) were the only Republicans to vote against the bill, while Rep. Colin Peterson (D-Minn.) was the only Democrat to support the measure.

The House bill would repeal the individual and employer mandates, the "Cadillac tax" on high cost employer sponsored health plans, and the 2.3 percent medical device tax. It would also eliminate the ACA's Prevention and Public Health Fund, and the law's requirement for larger employers to begin automatically enrolling new full-time employees in coverage. The bill would redirect funds for Planned Parenthood to community health centers for one year.

The Senate Parliamentarian recently ruled that the Senate could not repeal the ACA individual mandate and employer mandate through reconciliation. This will make it challenging for Republicans to send a budget bill that repeals these part of the ACA to President Obama's desk. Meanwhile, Senate Republicans face additional challenges in forming a collective voice among the party as Senate conservatives, Ted Cruz (R-Texas), Mike Lee (R-Utah), and Marco Rubio (R-Fla.) have said that they cannot support the bill because it does not fully repeal the ACA. Additionally, several moderate Republican members have expressed concerns about the Planned Parenthood provision. With a 54 member Republican majority, only three members can vote against the legislation to secure the 51 votes necessary for passage. The White House has said that the President will veto the package should it reach his desk.