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What to Watch for In the New Congress

As the new Congress prepares to take over at noon January 3, we are hearing more about their plans involving healthcare in the coming months.

House Republicans are accelerating their discussions over how to use the fiscal 2017 and fiscal 2018 budget resolutions to fast-track legislation with partial Obamacare repeal as a prime target.

Under the current interpretation of Senate rules, not all of Obamacare can be repealed using the fast-track process known as reconciliation. Only bills that are primarily budgetary in nature can benefit from the filibuster-proof process. That means that regulations governing insurance minimum standards of coverage and pre-existing conditions would have to be repealed separately.

There are several provisions that could be repealed by a simple majority using the budget reconciliation process in the new Congress.

  • Premium tax credits which help Americans whose incomes fall between 100% and 400% of the federal poverty level lower their monthly insurance premiums for coverage purchased through the Marketplace.
  • Penalties for failing to buy individual insurance.
  • Medicaid expansion, which 31 states and the District of Columbia took advantage of under the Affordable Care Act. The repeal threats create budget uncertainty for states that expanded Medicaid. The impact to California and New York alone could reach $21 billion.

It is expected that the repeal will not go into effect immediately, but may be delayed up to three years. This would give Republicans time to develop a replacement plan. Democrats have vowed to fight the repeal efforts and highlight for Republicans what harm a repeal will inflict. 

Urban Institute has issued a report on the consequences of a partial Obamacare repeal occurring before a replacement plan is in place. 

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