Sens. Lindsay Graham (R-S.C.) and Bill Cassidy (R-La.) Sept. 13 introduced legislation to repeal and replace the Affordable Care Act (ACA). The bill, supported by Sens. Ron Johnson (R-Wis.) and Dean Heller (R-Nev.) may represent the last opportunity for Republicans to pass health care reform legislation under reconciliation instructions, which expire on Sept. 30. Without reconciliation, the Senate will need 60 votes, not 50, to pass legislation to amend the ACA.
The bill is estimated to cost $1.2 trillion and would replace current tax credits and subsidies with block grants to states. Additionally, the bill would repeal several key provisions of the ACA, including the individual mandate, the employer mandate, and the medical device tax.
It is unclear if the bill has sufficient support to pass the Senate even under reconciliation. Other efforts to develop bipartisan legislation to stabilize the markets have been ongoing since the Senate returned from their August district work period, including a series of hearings in the Senate Health Education Labor and Pensions (HELP) Committee, spearheaded by Chair Lamar Alexander (R-Tenn.) [see Washington Highlights, September 8]. The Senate Finance Committee has also been examining various issues surrounding health care costs.
It remains to be seen whether Senate Majority Leader Mitch McConnell (R-Ky.) will bring the Graham-Cassidy bill to the floor for a vote, lend his support to ongoing committee efforts, or both. According to press reports, Sen. McConnell has told the bill's authors they must produce the 50 votes before he would consider taking the bill to debate. Pundits have also suggested the appetite to pursue health care reform may be slim due to the Senate’s three failed attempts to pass legislation in July, and a desire to move on to tax reform.
A section-by-section summary of the bill may be found here.