Senate’s ACA Repeal Effort Begins, Stalls, Eventually Fails

Early on Friday morning the U.S. Senate voted down the latest effort – termed “skinny repeal” – to dramatically alter the Affordable Care Act.  Three GOP Senators – Susan Collins (Maine), Lisa Murkowski (Alaska), and John McCain (Ariz.) – joined the unified block of Democratic Senators to defeat skinny repeal 49-51.

Collins and Murkowski had consistently opposed the GOP’s efforts to gut the ACA in the manner Senate Majority Leader Mitch McConnell (R-Kans.) proposed – without committee hearings, without a clear plan to assist the millions cut off Medicaid rolls, and, in the case of skinny repeal, with a provision to cut funding to Planned Parenthood.  McCain’s was the surprise vote on Friday.

During a dramatic vote on Tuesday to give the Senate authority to proceed on debate over repealing and replacing the ACA, McCain cast a key vote to proceed just days after undergoing brain surgery. (V.P. Mike Pence then broke the 50-50 tie.)

After Tuesday’s vote, subsequent votes failed to pass bills that would have scuttled the ACA entirely or scale back large parts of it – such as Medicaid expansion.

As the week drew to a close, Republicans focused on what was termed “skinny repeal” – which would repeal the individual mandate, among other sections of the ACA.  Passing any bill would have allowed the Senate to send its bill to a conference committee with the House, which has already passed its own repeal bill. The thinking was that in conference – not in committee and not on the Senate floor – the GOP could continue its work to further dismantle the ACA.

With Friday’s vote, it is now unclear what will happen next. McConnell indicated the Senate will return to normal non-healthcare-related business next week.
On Wednesday, Governor Baker joined governors from nine other states in a letter to U.S. Senate Majority Leader Mitch McConnell (R-Kans.) and Minority Leader Chuck Schumer (D-N.Y.) urging them to reject “skinny repeal.” The five Democratic and five republican governors wrote that such repeal is “expected to accelerate health plans leaving the individual market, increase premiums, and result in fewer Americans having access to coverage.”

On Friday MHA President & CEO Lynn Nicholas, FACHE, said she was relieved that the “ill-considered effort to tear down the advances of the Affordable Care Act and leave millions of Americans without health insurance” seemed to be at an end – at least for now. “MHA thanks both Massachusetts senators, Elizabeth Warren and Ed Markey, for their consistent, staunch support of the ACA, and is gratified that Senators Susan Collins, Lisa Murkowski, and John McCain cast courageous votes to oppose this misguided repeal-and-replace effort.”