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The Short Term Landscape Of The 115th

by Joel Kopperud, VP, Government Affairs

The 115th Congress was sworn in yesterday with high expectations to repeal Obamacare as soon as possible. A lot is changing in this break-neck environment, so stay tuned for more alerts and check out our Healthcare In Transition Hub for the latest information.

Yesterday, Senate Republicans officially kicked off the Repeal and Replace effort when Senate Budget Chairman Mike Enzi (R-WY) introduced a resolution containing fast-track instructions to repeal Obamacare through the reconciliation process.

Reconciliation is a Senate maneuver reserved specifically for budgetary items and only requires 51 votes to pass the chamber, as opposed to the Senate’s usual 60 vote threshold. The budget resolution instructs the House Ways and Means and Energy and Commerce Committee, and the Senate Finance and Senate HELP Committee, to immediately draft repeal legislation with the intent of sending a repeal bill to the President’s desk “as soon as possible.” You can read the Senate resolution here.

We do not expect the Senate to vote on the legislation until next week, at which point it should be easily passed by the House and signed by the president. The actual repeal legislation drafted by the authorizing committees will take more time, with some reports suggesting it could take up to two months. Democrats will stand united against the repeal effort (with the possibility of one or two defections), and Republicans remain divided over how much to include in the repeal bill, and on the timing of eliminating subsidies and ACA exchanges, with some members suggesting delaying those measures until after the 2018 or 2020 elections.

Separately, legislation to repeal the Cadillac tax was also introduced by Senators Dean Heller (R-NV) and Martin Heinrich (D-NM), and Representatives Mike Kelly (R-PA) and Joe Courtney (D-CT). The last Congress delayed the 40 percent excise tax by two years, making it effective in 2020. The repeal was also included in last year’s ACA repeal bill vetoed by President Obama, and the stand-alone repeal bill enjoyed the support of over two thirds of the House and 90 U.S. Senators.

While it still consistently tops the list of repeal items to be include in the initial Obamacare repeal bill, some strategists are suggesting that its wide support could incline some lawmakers to withhold the repeal measure from the first ACA repeal bill and slide it into the more controversial “replace” bill, using it as a tool to garner support from members that might otherwise be on the fence. That scenario is a long shot, as nobody knows what the controversial items will even look like in a replace bill right now, and The Council continues to advocate for its inclusion in the initial repeal bill.

We continue to advocate for the simplification of employer reporting requirements and the repeal of the Medical Loss Ratio in the first bill, and we continue to strongly defend the tax exclusion for employer sponsored insurance.

Taxing plans continues to be on the table as Congress looks to raise revenue to offset the tax cuts considered in the ACA repeal and a separate tax reform measure. Our guard is high and we don’t have any additional details on where this stands at the moment. We’ll keep you posted with more information as it develops.

We’re still eager for guidance and feedback, so please share any comments you have with me at or my colleague Joel Wood at at your convenience.

We will also be hosting perhaps one of our most critical Legislative Summits in February, and we will need your help to press Congress on our issues. Click here to register for the Legislative Summit.

The New House Rules

House Republicans on Tuesday evening also approved a rules package that paves the way for legislation repealing Obamacare. The package, which the House approved in a 234-193 vote, includes a provision exempting any Obamacare repeal or reform measures from congressional rules limiting how much legislation can increase direct spending. That should allow the House to roll back the health law even if its repeal legislation is projected to add to the deficit. (Senate Republicans included a similar provision in a budget resolution they unveiled on Tuesday.)

The exemption represents one of the first steps to dismantling large parts of Obamacare, which Republican lawmakers plan to do through reconciliation in the coming months.

Joel Kopperud, VP, Government Affairs: