A quick explainer on everything up to date for the Republican ACA repeal and replace effort.
Republicans have been threatening the repeal of the Affordable Care Act, commonly referred to as Obamacare, before it even passed into law in 2010. Seven years and several failed attempts later, the Senate Republicans are one step closer to making good on their threats. Yesterday the Senate voted 51-50 to begin debate on an Obamacare repeal plan. All 48 Democrats voted against the motion; while all but two Republicans voted in favor of the motion, including Senator John McCain who is being treated for a fatal form of brain cancer that was discovered thanks to taxpayer-provided health insurance. Only two Republicans, Susan Collins of Maine and Lisa Murkowski of Alaska, joined Democrats in voting against the motion.
Now that the procedural motion has passed, Senators will begin debating. There are and were three proposals up for Senate consideration: 1) Better Care Reconciliation Act (BRCA) which would have taken healthcare insurance away from 22 million people, 2) Obamacare Repeal Reconciliation Act (ORRA) which would repeal and not replace, leaving 32 million without healthcare insurance, and 3) ”Skinny Repeal” which would leave most of the ACA in place but would eliminate a tax and the mandates on employers and individuals. BRCA failed with a 43-57 vote.
Each party will receive 10 hours of floortime for debate. During this time, Senators will take turns making speeches about healthcare. The 20 hours will likely stretch over the span of a few days. After the 20 hours is complete, a series of amendments will be added to the original bill. Each amendment requires 51 votes to be approved and must be relevant to healthcare. Once all approved amendments are added, majority leader, Senator Mitch McConnell, will offer a final bill, which will encompass the plan Senate Republicans want to pass. The final bill will go up for a vote; it will need 51 votes to pass. In the event of a tie, Vice President Mike Pence can vote.
What it means:
The repeal of Obamacare will hurt millions of the most vulnerable and marginalized people in the United States, especially people on Medicaid and people with a preexisting condition. A potential Medicaid cut would withdraw over $700 billion from the program over the next 10 years. Other people who will face more hardship if Obamacare is repealed include children in special education programs, Planned Parenthood patients, people who are addicted to opioids, pregnant folks and new parents, and low-income people not on Medicaid.
The Congressional Budget Office (CBO), a nonpartisan federal agency within the legislative branch that provides budget and economic information to Congress, concluded that 17 million people would lose insurance coverage the first year the ACA is dismantled. In addition, the CBO predicts that those who would not lose the insurance completely would be paying 25 percent more for their premiums during that first year. After a decade, 32 million people would lose their health insurance and premiums would double.
It took a lot of politicking from Senator McConnell to get to this point due to the grim conclusions made by the CBO and other analysts. The Republicans barely had the votes to begin debate on a repeal. Senator McConnell acknowledged that this vote was only the beginning in a series of political moves aimed at ending Obamacare:
“This is just the beginning. We’re not out here to spike the football,” McConnell said after the vote.
What can you do about it?
It’s important to keep in mind that the bill has not been passed yet. It’s easy to feel defeated with so much bad news coming from Washington D.C., but Trump isn’t signing the repeal into law just yet. In the meantime, resist. Be vocal. Arm yourself and your networks with factual information. Call your Senator, especially if you live in a state with a swayable Republican.
There are also other non-governmental ways to get involved: many communities have liberal public health non-profits like Planned Parenthood or Saint Jude’s that regularly treat at-risk populations in need. You can donate to these organizations directly.
Also since most legislation implements on a multi-year delay, the possible repeal wouldn’t go into place immediately. This means that the 2018 midterm elections could have huge implications on the future of healthcare in the country.
So registering to vote, engaging with your local and national representatives, and becoming a more active citizen in civic organizations and non-profits all give you an opportunity to express discontent with the new legislation. And finally, the First Amendment protects your right to protest. So be sure to look out for organizations that are planning demonstrations that express discontent with the new Senate bill or just show up and protest by yourself. Make your voice heard in whatever way you can.