Healthcare Reform News Update for July 26, 2017
Senate Votes Against First ACA Repeal, Replacement Proposal
In a 43-57 vote, the Senate opposed an initial repeal-and-replacement proposal for Obamacare on Tuesday night. The vote rejected the Senate’s healthcare bill (the Better Care Reconciliation Act) and proposals from Senators Ted Cruz (R-TX) and Rob Portman (R-OH). This was the first amendment to get a vote after the Senate picked up the American Health Care Act, the House-passed bill that is being used as a vehicle for any Senate action.
Which Bills Will the Senate Vote on Next?
Wednesday afternoon: The Senate will vote on a repeal-and-delay bill with the Paul amendment, which would ban the use of subsidies to buy plans that cover abortion. If that bill does not pass, the Senate will vote on whether or not to return healthcare reform bills to a bipartisan process.
Later: If senators cannot agree on a comprehensive repeal or replacement for Obamacare, Republicans may move forward with a “skinny” repeal. The smaller repeal would eliminate the individual mandate, the employer mandate, and the medical device tax. The scaled-down bill would allow the Senate to succeed in passing a bill and start negotiations with the House.
The Senate may also vote on a Graham-Cassidy amendment, which keeps the ACA’s taxes and allows states to administer health insurance. As a note, Senate members still have time to propose new healthcare bills.
Senate Parliamentarian Advises Against Two Additional Senate Bill Provisions
Two more provisions from the Republican healthcare bill may not meet reconciliation standards, Senate Parliamentarian Elizabeth MacDonough said Tuesday. If the provisions are argued against and found to fall outside of reconciliation standards, they will need 60 votes (rather than 51) to be included in a healthcare bill. The two provisions advised against: 1) allowing insurance companies to increase the amount they charge older individuals in comparison to younger ones and 2) allowing small businesses to create association health plans.
Healthcare Reform News Update for July 25, 2017
Senate Healthcare Bill Advances With 51-50 Vote
Vice President Mike Pence cast the tiebreaking vote to move the legislation to repeal Obamacare to floor debate. Senator John McCain (R-AZ), who was recently diagnosed with brain cancer, returned to Washington on Tuesday to participate in the Republican-led healthcare vote. He voted in favor of the legislation—a critical move after fellow senators Susan Collins (R-ME) and Lisa Murkowski (R-AK) expressed their opposition. Here’s a closer look at how each senator voted.
President Donald Trump praised the Senate and thanked McCain for advancing the legislation: “I’m extremely happy that we got this vote. This is the tough vote to get. Now we’re all going to sit together, and we’re going to try and come up with something that’s really spectacular. We have a lot of options and a lot of great options. And the Republican senators really went out there—it’s not easy.” Trump criticized Collins and Murkowski’s opposition, saying the result is “very, very sad for them.”
The legislation will move to floor debate; however, it’s not guaranteed what the final bill will look like or if there will be enough votes to pass it.
Democrats Lay Out a 3-Tier Approach to Lowering Prescription Costs
- The proposal would “create an independent, Senate-confirmed ‘price gouging’ enforcer to identify medicines with ‘unconscionable’ price increases and impose fines on manufacturers that are proportional to the size of the price hike. Money paid will be given to the National Institutes of Health (NIH) to further its work on new drug development.”
- Drug makers would also be required to publicly justify extreme pricing increases to the U.S. Department of Health and Human Services (HHS) at least 30 days before the cost change will begin
- The government would be allowed to negotiate prescription drug prices for medications covered by Medicare Part D.
Healthcare Reform News Update for July 24, 2017
Senate Parliamentarian: Parts of Updated Bill Don’t Meet Reconciliation Rules
Abortion provisions in the Senate bill would need a super-majority vote, Senate Parliamentarian Elizabeth MacDonough said Friday. Provisions eliminating Medicaid coverage requirements, altering medical loss ratios for insurance companies, and pertaining directly to New York would require a super-majority vote, MacDonough said. That means these provisions would need 60 favorable votes to pass and follow Senate rules (rather than the 50 Republicans anticipated) because they do not follow reconciliation rules.
Senate Republicans Determined to Hold Healthcare Vote This Week
Senate Majority Leader Mitch McConnell (R-KY) is pressing forward to hold a vote this week on healthcare reform. Two key factors remain unclear: which legislation will be voted on and whether or not Republicans have the necessary support to move the bill forward.
Senator Susan Collins (R-ME) told “Face the Nation” that Senators “don’t know whether we’re going to be voting on the House bill, the first version of the Senate bill, the second version of the Senate bill, a new version of the Senate bill, or a 2015 bill that would have repealed the Affordable Care Act now and then said that somehow we’ll figure out a replacement over the next two years.”
Senator Rand Paul (R-KY) echoed Collins’ confusion, telling CNN’s “State of the Union,” “The real question is, what are we moving to? What are we opening debate to?”
A Look at Premiums, Deductibles Under the ACA Versus the Senate Healthcare Bill
The Kaiser Family Foundation has published an interactive map comparing premiums and tax credits under the Affordable Care Act (current law) and the Better Care Reconciliation Act (Senate healthcare bill). The map includes estimates by county, age, and income.
The Hill has reported on the Congressional Budget Office’s (CBO) analysis of the Senate healthcare bill, specifically on drastically increasing deductibles. The CBO found that “a standard benchmark plan under the GOP bill could face a deductible of $13,000 in 2026.” Under Obamacare, someone making around $57,000 would have a deductible of $5,000, and someone making around $27,000 would have a deductible of $800.