ACA Repeal and Replacement Update – March 30, 2017

Top takeaways from the week

1) House Speaker Ryan said he doesn’t want President Trump to work with Democrats on new healthcare legislation; 2) Republicans continued discussions on a way forward on ACA repeal; 3) House Energy & Commerce Chair Walden signaled support for including cost-sharing reduction payments in the upcoming appropriations bill; and 4) HHS Secretary Price indicated that he will carry out the ACA as long as it remains the law.

After the defeat of the American Health Care Act last Friday, policymakers spent the better part of this week trying to determine next steps. While congressional leadership and the White House initially claimed that healthcare reform efforts had been put on hold for the foreseeable future, negotiations have continued in an effort to gain consensus around a strategy forward.

On Monday, House Speaker Ryan (R-WI) told a gathering of donors that Republicans’ push for healthcare reform will continue because health reform is “too valuable” to ignore and “we are not giving up.” However, despite calls from many to push for a bipartisan solution, on Thursday, Speaker Ryan said “If this Republican Congress allows the perfect to be the enemy of the good, I worry we’ll push the President into working with Democrats.”

House Action

House Speaker Ryan met with Vice President Pence and other senior officials at the White House on Monday to map out a path forward on reform. While noting his intention to continue efforts to repeal the ACA, Speaker Ryan refused to commit to a timeline or detail, noting “I won’t tell you the timeline because we want to get it right.”

House Republicans met on March 28 to assess how to restart healthcare negotiations. Afterwards, House Majority Leader McCarthy (R-CA) said that “we promised that we would repeal and replace Obamacare, and that’s exactly what we’re going to do. The timeline wasn’t there. The votes were not there yet. That doesn’t mean we’re not going to get there.” House Republican whip Steve Scalise (R-LA) also noted that “we are closer to repealing Obamacare than we ever have been before.”

In an effort to find common ground and move forward with a repeal bill, House Freedom Caucus Chair Meadows (R-NC) has continued to meet with members of the moderate Tuesday Group. However, the two sides have reportedly struggled to compromise on a strategy.

House leadership have begun to call for interventions to stabilize the marketplaces, as insurers are currently developing the premiums and benefit packages for health plans offered in 2018. House Committee on Energy & Commerce Chair Walden (R-OR) on Tuesday indicated a willingness to appropriate funds for cost-sharing reductions, and on Thursday said that the funds should be included in the continuing resolution, noting “It is a big issue we need to address into the future and probably sooner rather than later because insurers are trying to figure out what the marketplaces will look like” in 2018. House Appropriations Committee Health Subcommittee Chair Cole (R-OK) also indicated support for continuing payments for cost-sharing reductions.

Meanwhile, House Minority Leader Pelosi (D-CA) sent a Dear Colleague letter to House Democrats on Tuesday requesting that members send their ideas and specific suggestions to strengthen the ACA, to be discussed during a Leaders meeting on Wednesday morning. Letter:

Senate Action

Despite renewed optimism for repeal efforts by some in the House, Senate Republicans continue to express caution with respect to healthcare reform. Senate Majority Leader McConnell on Tuesday noted that “It’s pretty obvious we were not able in the House to pass a replacement.”

In a nod to the need to work across the aisle, Senate Majority Whip Cornyn (R-TX) noted that reform “needs to be done on a bipartisan basis, and so we’re happy to work on it with Democrats if we can find any who are willing to do so.” Additionally, Sen. Grassley (R-IA) noted that “major social policy…must be bipartisan.” And, Sens. Cassidy (R-LA) and Collins (R-ME) are hoping to convince both Republicans and Democrats to back their health insurance overhaul, the Patient Freedom Act, introduced in January.

Senate HELP Committee Chair Alexander (R-TN) stated that he is ready to discuss bipartisan solutions to stabilize the market while Congress works on a long-term overhaul, and on Wednesday, he and Sen. Corker (R-TN) introduced the Health Care Options Act of 2017 (S. 761), which would allow Americans who live in counties in which there are no health insurance options on the ACA exchanges to use their subsidy to purchase any health insurance plan outside of the exchanges. Press release: Summary:

Meanwhile, Senate HELP Committee Ranking Member Murray (D-WA), Sen. Cantwell (D-WA) and 42 other Democratic Senators sent a letter to President Trump on Wednesday, urging him and his administration to abandon their efforts to repeal the ACA and further disrupt the U.S. health care system. Press release with text of letter:

Administrative Action

In a hearing on HHS fiscal year (FY) 2018 appropriations on Wednesday, HHS Secretary Price deferred on several questions related to the administration’s strategy moving forward with respect to the ACA, including whether it would continue to fund cost-sharing reductions. Secretary Price did note that “so long as the law is on the books, we at the department are obligated to uphold the law.”



For top healthcare policy lobbyists in DC, contact Sirona Strategies.