Senate Continues Health Care Debate; House Prepares to Join Discussions

The Senate continued to debate legislation to repeal the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) into the evening on July 27. At press time, votes on amendments to the House-approved American Health Care Act (AHCA) (HR 1628) (TAXDAY, 2017/07/26, C.1) were expected to run into the early morning hours of July 28.

An amendment by Sen. Steven Daines, R-Mont., was shot down on July 27, without receiving one “yes” vote. The amendment proposed a single-payer health-care system. Although Daines announced he did not support a single-payer system, he intended the vote to record which Democratic senators do. However, most Democrats merely voted “present” on the measure, calling the move a “trick” and a “sham.”

Much of the discussion among senators on Thursday evening centered around a forthcoming vote on a “skinny repeal” amendment, which would likely repeal only some provisions of the ACA. Among other provisions, the bill is expected to repeal the individual and employer mandates. The “skinny repeal” is intended by Senate leadership to move a measure to conference, where the House and Senate can craft a final bill.

“I will support legislation to move this process to a House-Senate conference because I believe we need to repeal and replace Obamacare,” Sen. Rob Portman, R-Ohio said in a July 27 tweet. Sens. Lindsey Graham, R-S.C., John McCain, R-Ariz., Ron Johnson, R-Wis., and Bill Cassidy, R-La., however, gave a press conference on July 27 expressing concerns with the “skinny repeal.” The lawmakers said they would not vote for the skinny repeal without assurance from the House that it would not become the final product and would instead only serve as vehicle to get to conference.

“If moving forward requires a conference committee, that is something the House is willing to do,” Ryan said in a statement released after 7:00 p.m. on July 27. “We expect the Senate to act first on whatever the conference committee produces,” he added. At press time, the House GOP conference was expected to meet on July 28 at 9:00 a.m., according to several reports.

CBO

In response to a request by Senate Democrats, the Congressional Budget Office (CBO) released its estimate that the so-called “skinny repeal” would cause an additional 16-million people to be uninsured by 2026. The estimate also purported that $130.2 billion would be saved over a 10-year period.

Sen. Bob Menendez, D-N.J., took to Twitter on July 27 to criticize the skinny repeal proposal as a disaster. “Make no mistake: skinny repeal means hefty premium hikes and huge health insurance losses,” he said.

Meanwhile, House Majority Leader Kevin McCarthy, R-Calif., issued an announcement to House lawmakers that the August recess scheduled to begin the week of July 31 is subject to change. “While last votes are currently scheduled to take place tomorrow, members are advised that—pending Senate action on health care—the House schedule is subject to change,” McCarthy said. “All members should remain flexible in their travel plans over the next few days. Further information regarding potential additional items will be relayed as soon as possible.”

CBO Estimate of the Direct Spending and Revenue Effects of Selected Provisions from HR 1628, the Better Care Reconciliation Act of 2017, an Amendment in the Nature of a Substitute

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