Senate Parliamentarian Allows Bill To Dismantle ACA To Proceed
On Tuesday, the Senate parliamentarian ruled that a budget reconciliation measure (HR 3762) that would dismantle the Affordable Care Act by repealing some of its major provisions can move forward, Politico reports. However, lawmakers must make some changes to the bill to ensure it complies with Senate reconciliation rules, the parliamentarian said (Kim, Politico, 11/10).
The budget reconciliation process allows legislation to advance through the Senate on a simple majority vote. The process can be used to target aspects of the ACA that address spending and revenue, meaning the technique could not uproot the entire law (Bolton, The Hill, 11/10). The House last month voted 240-189 to approve HR 3762, which aims to dismantle the ACA by repealing the law's:
- "Cadillac" and medical device taxes; and
- Individual and employer mandates.
In addition, the measure would strip federal funding from Planned Parenthood for one year and redirect some of the funding to community health care centers.
According to the Congressional Budget Office, the legislation would reduce federal spending by $79 billion over 10 years (Fram, AP/San Francisco Chronicle, 10/23).
Bill Clears Procedural Hurdle, but Changes Must Be Made
According to Politico, the Senate parliamentarian ruled that some of the bill's provisions do not comply with Senate requirements for budget reconciliation measures.
According to a senior Democratic Senate aide, the parliamentarian said the bill's repeals of the ACA's individual and employer mandates do not meet the requirements. However, aides to Senate Majority Leader Mitch McConnell (R-Ky.) said GOP lawmakers will offer a substitute amendment to the bill that will change it to ensure it complies with the rules while preserving all of the bill's current repeal provisions.
Further, the bill's provision to defund Planned Parenthood does meet the standards for reconciliation measures (Politico, 11/10).
Senate GOP Leaders Could Broaden Measure Amid Pressure From Conservatives
After the budget reconciliation measure passed the House, three conservative senators said they plan to oppose the bill because it does not go far enough to repeal the ACA. The bill cannot pass the Senate if just five Republicans vote against it.
Amid the pushback, Republican leaders in the Senate said they could alter the measure to repeal certain other ACA provisions. A Senate GOP aide has said Republican leaders aim to "pass a more conservative ObamaCare repeal," adding, "they want to significantly expand on the House bill."
Senate Majority Whip John Cornyn (R-Texas) on Monday said the Senate could broaden the measure when it reaches the floor. According to Cornyn, "Everybody will be able to offer amendments so we'll have a vote-a-rama." He added that GOP Senate leaders would allow the bill to "go as far as we can consistent with Senate rules."
Still, the aide noted that leaders "need to figure out how far they can go without losing" votes. For example, while some conservative lawmakers have called for the bill to include a repeal of the ACA's Medicaid expansion, such a provision could be "complicated for some Republicans," according to the aide. The aide noted that if Senate GOP leaders cannot get the votes needed to pass a broader version of the bill, the chamber will instead vote on the version passed in the House.
Chances of Passage
According to Senate aides, the chamber might not consider the measure until December because there are not yet enough votes to pass it (The Hill, 11/10).
Meanwhile, the Obama administration has said President Obama would veto the reconciliation measure if it passes through Congress. Republicans likely lack the votes needed to override a veto (AP/San Francisco Chronicle, 10/23).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.