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    Senate Fails to Pass ACA Repeal and Replace Legislation: What’s Next?

    August 03, 2017

    On July 28, three Republican Senators joined with all 48 Democrats to defeat the GOP leadership’s “skinny repeal” bill that would have repealed the Affordable Care Act’s (ACA) individual mandate and removed penalties under the employer mandate for eight years, while delaying the medical device excise tax until the end of 2020. Senators Collins (R-ME), Murkowski (R-AK) and McCain (R-AZ) voted against the bill and urged their colleagues to move forward in a bipartisan fashion — through regular order – to fix problematic areas of the ACA.

    As August began, Democrats and Republicans started to embrace this approach with Senate HELP Committee Chair Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) announcing a series of committee hearings on healthcare reform for September that will feature testimony from state insurance commissioners, patients, governors, health care experts and insurance companies. On the House side, 43 lawmakers have come together as the Bipartisan Problem Solvers Caucus and have unveiled a proposal that they believe will “stabilize health insurance markets and provide relief to individuals, families and small businesses.” 

    The Problem Solvers Caucus plan would:

    • Bring cost-sharing reduction (CSR) payments under the Congressional oversight and appropriations process, while also ensuring mandatory funding for those payments
    • Create a dedicated stability fund that states can use to reduce premiums and limit losses for providing coverage, particularly for those with pre-existing conditions
    • Adjust the employer mandate by raising the threshold on the requirement for employers to provide insurance under the employer mandate to businesses of 500 employees or more and revising the definition of “full time” to indicate that a full-time work week is at least 40 hours;
    • Repeal the 2.3 percent excise tax on medical devices
    • Provide technical changes and clear guidelines to sections 1332 and 1333 of the Affordable Care Act for states that want to innovate on the exchange or enter into regional compacts to improve coverage and create more options for consumers