On January 26, 2017, key members of the GOP met in Philadelphia for a health care summit. With a goal to establish an ACA-replacement platform by consolidating varying proposed legislative bills, the Republican leadership left the city of Brotherly Love with little actionable progress. “We are still developing what this thing is going to look like,” Senator, Jim Risch of Idaho told reporters in Philadelphia. Similarly, Kevin Brady of Texas, the Chairman of the House Ways and Means Committee, said, “We’re just working really productively right now so no timetable has been set.”
Despite the lack of immediate clarity, steps to repeal and replace the Affordable Care Act (ACA) are underway. An initial action through the budget-specific reconciliation process, requiring a simple majority vote in the Senate rather than the customary 60-vote filibuster-proof vote, has occurred. Additionally, members of both the Republican party and the anticipated cabinet have proposed seven replacement plans, including one Democratic plan.
Further, President Trump’s executive order, issued on the evening of his inauguration, gave instruction to regulatory bodies to minimize the burdens in implementing the ACA; however, this order was largely symbolic. In line with several actions by the new administration, the executive order sent a signal and set a tone. However, the process of “repealing and replacing” the ACA remains in limbo as the leadership of the Republican-led Congress, key congressional committees and the Department of HHS vet options, weigh funding considerations, collect bi-partisan buy-in and continue budgetary assessments.
Stakeholders are waiting for a pattern to emerge among the potential plans. Ultimately, this process is anticipated to include multiple legislative bills. Once the bill(s) have momentum within a feasible timeline, these efforts will require democratic support to reach the 60-vote threshold. In short, “replace” cannot occur via a one-stop sweep. While President Trump’s executive order and the recent steps in the Congress send a clear message, the debate continues as to the timeline, procedure and cost projections for a new health care law to come to fruition.
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