Nothing has changed yet. Nothing will change until after Donald Trump is sworn in as President on January 20th. It’s all speculation right now as to what parts of the Affordable Care Act (ACA) will get repealed, what it will get replaced with, and when all of this will occur. There are lots of different ideas floating around on repeal strategies, but there doesn’t appear to be a mutual agreement amongst Republicans on a repeal strategy at this time. That will have to work its way through Congress, but the process has already begun. 

 

Where do current repeal efforts stand? Newly elected Senators and House of Representative members took office on January 3rd making up the 115th Congress. In just a matter of days, this new Congress is already showing that they are serious about a repeal. On January 12, 2017, the Senate passed the budget resolution. The following day, the House voted and also passed it. 

 

What exactly does that mean? Passing the budget resolution doesn’t directly or immediately change any part of the ACA. It just means that Congress can use the federal government’s budget to pick apart various pieces of the ACA, at least those that impact federal expenses and revenues. 

 

Why is this important? It’s likely the only way Congress could repeal parts of the ACA. In order to fully repeal the ACA, a super majority vote would be needed in the Senate. That means 60 Senators would have to vote to repeal the ACA, but Republicans only have 52 elected Senators. However, making changes to the federal budget only requires a simple majority vote, or 51 Senators, which the Republicans have.  

 

What could get repealed? As previously mentioned, only things that impact the federal budget could be repealed under this process, but that’s a lot of things. It includes the Individual Mandate, Employer Mandate, Exchange subsidies, Medicaid expansion, and more. Things unrelated to the federal budget could not be changed under this process. That includes the prohibition of denying coverage to someone based on their medical history, covering dependent children up to age 26, covering in-network preventive care at 100%, and more. 

 

What’s next? That is the million-dollar question. It’s probably more appropriate to say that is the trillion-dollar question since healthcare reform comes with such high costs. The best answer right now is we’ll just have to wait to see what happens.