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EMHS, the ACA, and Repeal and Replace

Last Friday, as President Donald J.Trump was sworn into office, intense national debate continued to swirl around “repeal and replace” of the Affordable Care Act (ACA). As we progress forward into the President’s first 100 days in office, we anticipate that repeal and replace will be a continued focus of discussion as many individual Americans as well as health delivery organizations wait to find out what changes are ahead for healthcare. 
 
On January 12, the United States Senate passed legislation allowing Congress to repeal the health law with a simple majority vote, rather than the 60 votes most bills need to clear the Senate. Lisa Harvey-McPherson, RN, EMHS vice president of government relations, shares, “This majority allows Senate leadership to use a reconciliation process to pass budget legislation. In terms of repealing the ACA, this means the entire law cannot be repealed, only the portions of the law that deal with spending or revenue, not policy.” This ACA budget bill instructs four committees in the House and Senate to draft bills meeting budget targets—the bills will then be reconciled into one package. The budget instructions include establishing a reserve fund to provide resources for ACA replacement. Instructions also set a fast-paced timeline for committees to report back their bills by January 27.
 
Optimally, Congress would, at the same time, vote to both repeal and replace the ACA. It remains unclear if Congress will pass legislation to repeal and replace the ACA simultaneously or repeal portions of the ACA and delay the impact of coverage changes. Over the past month, this has been the subject of significant debate and more Republicans are expressing support for a coordinated package fearing that not doing so could result in uncertainty in the insurance market and among the 20 million people who have received coverage under the law. A coordinated package could include a multi-step process involving repeal of portions of the ACA via the budget reconciliation bill followed by a series of bills before committees in the House and Senate intended to replace portions of the ACA along with administrative changes to the ACA implemented by the Secretary of the Department of Health and Human Services.
 
Fulfilling her commitment to prioritize the repeal and replacement of the ACA in a coordinated legislative package, U.S. Senator Susan Collins (R-ME) announced this week that she is sponsoring the Patient Freedom Act of 2017. Senator Collins' bill allows states that want to keep the Affordable Care Act provisions to do so and offers states the flexibility to design their own health plans with funding from the ACA. The bill, co-sponsored with fellow Republican Senator Bill Cassidy from Louisiana, is the first piece of legislation to engage the Senate in a debate to create a comprehensive solution moving forward.
 
While much is yet to be determined, we can be sure of Maine’s Congressional delegation’s commitment to fight for continuous coverage for those Maine citizens who are insured through the federal health insurance exchange. “EMHS leaders are working closely with Senator Collins, Senator Angus King (I-ME), Representative Chellie Pingree (D-ME), Representative Bruce Poliquin (R-ME), and their staff to communicate our priority to have ACA repeal and replace occur simultaneously as they evaluate a variety of initiatives in the House and Senate,” affirms Lisa. As we learn more, we will update you on the status of ACA repeal and replacement legislation as it moves from committee work to the House and Senate chambers.