The Senate July 28 failed to pass legislation to repeal the Affordable Care Act (ACA, P.L. 111-148 and P.L 111-152). The final vote on a “skinny bill,” which would have repealed both the individual and employer mandates, delayed the medical device tax, increased the contribution limits for health savings accounts (HSA), among other items, failed by a margin of 49-51 with Republican Senators Lisa Murkowski (R-Alaska), Susan Collins (R-Maine) and John McCain (R-Ariz.) voting against the bill.
Several legislative vehicles to repeal the ACA were presented and failed prior to the final vote. These vehicles included:
- The Obamacare Repeal Reconciliation Act (ORRA), an updated version of a 2015 repeal bill that passed the House and Senate but was ultimately vetoed by President Obama. The ORRA failed by a vote of 45 to 55 with seven Republicans opposing the measure.
- Those “No” votes included: Senators Alexander (R-Tenn.), Capito (R-WV), Collins (R-Maine), Heller (R-Nev.), McCain (R-Ariz.), Murkowski (R-Alaska), Portman (R-Ohio).
- The Better Care Reconciliation Act (BCRA), the Senate repeal and replace bill. The BCRA failed by a vote of 43 to 57 with nine Republicans voting against it.
- Those “No” votes included: Senators Collins (R-Maine), Corker (R-Tenn.), Cotton (R-Ark.), Graham (R-S.C.), Heller (R-Nev.), Lee (R-Utah), Moran (R-Kan.), Murkowski (R-Alaska), and Paul (R-Ky.)
In a July 28 statement, AAMC President and CEO Darrell G. Kirch, MD, expressed his gratitude, “On behalf of the patients we care for, we thank the Senate for voting to protect the health of millions of Americans—including those on Medicaid and with preexisting conditions—whose coverage was in jeopardy. Now it is more important than ever that Congress and the administration work together to improve the current system and ensure that all Americans have access to affordable, comprehensive coverage.”
The final vote was a culmination of months of back-and-forth where both House and Senate Republicans had difficulty garnering support for their legislation [see Washington Highlights, July 21, June 23, and May 5]. The House will now begin its August district work period and the Senate is expected to follow in mid-August. Next steps on health reform remain unclear at this time.