One of the campaign promises of the new Trump Administration is the repeal and replace the Affordable Care Act. (ACA). In fact, the attempt to repeal and replace the ACA began even before Donald Trump was elected president. As soon as the Democrats lost the control of the house in 2011, Republican lawmakers, the first bill introduced in the house was the Repealing the Job-Killing Health Care Law Act in 1st May 2011 by Rep Eric Cantor (R-VA). The house passed the bill by Rep Cantor but rejected by the Senate (The US Congress 1-2). Later in 2013, there was a Federal government shutdown in an attempt to pressure the Obama Administration to delay the implementation of the ACA (Hellman 1). The government shutdown ended after the President signed the Continuing Appropriations Act 2014 which meant there would be no premium tax credits under the ACA (Hellman 1).
The last attempt to repeal ACA under the Obama Administration was in February 2015 when the house passed the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015. However, the president vetoed the bill, and the house failed to override the veto (The White House 1-2). Later in the new Trump Administrations began, the process of replacing the ACA through an executive order signed by the president which would minimize the economic impacts of ACA (The White House 1-2).
We can do it today.
After the executive order, the house announced a bill called the American Health Act which would replace the ACA but was withdrawn for lack of enough votes in the Senate (Berman 3). The failure of this bill in the Senate is because Senate wanted to write its version of the bill instead of the passed American Health Care Act (Berman 3). The Senate version was dubbed the Better Care Reconciliation Act of 2017 and would reduce the tax credits for Americans purchasing insurance on the individual market (Berman 3). However, the Senate version failed to pass in the Senate after an initial 50-50 vote which would require Vice President Pence to break the tie (Berman 3).
After the failure of the Better Care Reconciliation Act, the House introduced the Health Care Freedom Act to replace the ACA but failed to receive enough votes in the Senate. All Democrats, Independents, and three Republican Senators voted against the bill (Becker 1). Currently, Senators Bill Cassidy (R-LA) and Lindsey Graham (R-SC) are currently drafting another health care bill that replaces ACA (Mukherjee 1). It is unlikely whether all Republicans will support the proposed bill, but the proposed legislation is aimed at reducing cuts to the Medicaid program. If the Republicans win the scheduled US Senate special election in Alabama on December 12th, it is highly likely that the bill would pass in the Senate (Kane 1).
Evidently, it is an upheaval task to replace the ACA. A dominating hurdle that impedes the repeal and replacement of ACA is lack of enough votes, especially in the Senate. The failure to pass the replacement in Senate is because of the phenomenon of the filibuster, which is a Dutch word that means ‘pirate.’ Based on the tenets of the filibuster, a bill requires a two-thirds majority vote in the Senate is required to pass a bill into law (United States Senate 1). This implies the Republican Controlled Congress needs at least 60 votes in the senate. However, the Republican Party only has 52 Senators in Congress, making it difficult to repeal and replace the ACA without input from Democratic Senators (Luhby 1). Furthermore, some senators within the Republican Party are not certain to vote for any proposals to repeal and replace ACA. Statistics from Congress show that 13 Republican senators from 12 states have opposed at least one of the five major repeal efforts in Congress (Andrews, Park and Parlapiano 1). In fact, a noteworthy Republican Senator John McCain famously voted against the vote to repeal ACA though his campaigned vigorously on Repeal and Replace (Becker 1-3).
- Andrews, Wilson, Haeyoun Park and Alicia Parlapiano. “The Republican Senators Who Have Opposed the Many Bills to Repeal Obamacare.” 26 September 2017. The New York Times. <https://www.nytimes.com/interactive/2017/09/25/us/republicans-who-opposed-the-senate-health-care-bills.html>.Print
- Becker, Amanda. “Trump blasts McCain, pressures senators to support Republican healthcare bill.” 23 September 2017. Global News. <https://globalnews.ca/news/3765455/trump-john-mccain-healthcare-bill/>.Print
- Berman, Rusell. “What’s in the Senate Republican Health-Care Bill.” 22 June 2017. The Atlantic . <https://www.theatlantic.com/politics/archive/2017/06/whats-in-the-senate-republican-health-care-bill/531258/>.Print
- Collins, Eliza. “Alaska Sen. Lisa Murkowski is the key vote on the Obamacare repeal, and everyone wants her on their side.” September 2017. USA Today. <https://www.usatoday.com/story/news/politics/2017/09/21/alaska-sen-lisa-murkowski-key-vote-obamacare-repeal/689159001/>.Print
- Hellman, Aaron. “Why Did the U.S. Government Shut Down in October 2013?” 2013. HUFFPOST. <https://www.huffingtonpost.com/quora/why-did-the-us-government_b_4064789.html>.Print
- Kane, Paul. “Everything is on the line for McConnell in Tuesday’s Alabama Senate primary.” 23 September 2017. The Washington Post. <https://www.washingtonpost.com/powerpost/everything-is-on-the-line-for-mcconnell-in-tuesdays-alabama-senate-election/2017/09/23/c293fa84-9fce-11e7-9083-fbfddf6804c2_story.html?utm_term=.1bdad9681f8d>.Print
- Luhby, Tami. “Why it’s so hard to replace Obamacare.” 13 January 2017. CNN Money. <http://money.cnn.com/2017/01/13/news/economy/replace-obamacare-congress/index.html>.Print
- Mukherjee, Sy. “Republicans May Be 1 Senator Away From Repealing Obamacare. Here’s What to Know.” 18 September 2017. Fortune Magazine. <http://fortune.com/2017/09/18/graham-cassidy-bill-repeal-obamacare/>.Print
- The US Congress. “H.R.2 – Repealing the Job-Killing Health Care Law Act.” 2011. CONGRESS GOV. <https://www.congress.gov/bill/112th-congress/house-bill/2>.Print
- The White House. “Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal.” 20 January 2017(b). <https://www.whitehouse.gov/the-press-office/2017/01/2/executive-order-minimizing-economic-burden-patient-protection-and>.Print
- “Veto Message from the President — H.R. 3762.” 08 January 2016. <https://obamawhitehouse.archives.gov/the-press-office/2016/01/08/veto-message-president-hr-3762>.
- United States Senate. “Filibuster and Cloture.” 2017. <https://www.senate.gov/artandhistory/history/common/briefing/Filibuster_Cloture.htm>.Print