Repealing ACA: A complicated task

By: Libby Mullin

Congress began the process to repeal the Affordable Care Act (ACA) two weeks ago, but the effort to repeal the law fully and, ultimately, replace it is a complicated and challenging task. There is a long way to go before any of the existing provisions are fully off the books. This blog post summarizes the process Congress is using and shares the Children's Dental Health Project's (CDHP) perspective on where things are headed.

The process Congress is using is known as “budget reconciliation,” which allows the Republicans in the U.S. Senate to pass the measure with 51 votes (instead of the typical 60). Both the Senate and House have passed budget resolutions and now the work of crafting details on a replacement plan turns to the four health care committees (Senate Finance Committee; Senate Committee on Health, Education, Labor & Pensions; House Ways and Means Committee; and the House Energy and Commerce Committee).

A growing number of Senate Republicans are demanding that a meaningful replacement package be negotiated and agreed upon before a full repeal.

By law, the House is required to pass its budget reconciliation first and send it to the Senate where it can be amended. If the House and Senate versions differ (which they are likely to), those versions will need to be worked out via a House-Senate conference committee and then voted on again by each body.

House Speaker Paul Ryan has promised to accomplish his reconciliation bill in the first 100 days of the Trump Administration, and recent reports suggest the House vote could be taken as early as late February.  What is far less clear is how detailed the House plan will be, what those details will look like — and whether or not the Senate will be willing to accept its approach. 

A growing number of Senate Republicans are demanding that a meaningful replacement package be negotiated and agreed upon before a full repeal. Not surprisingly, these members are hearing a chorus of concerns from constituents strongly opposed to rushing towards a repeal and jeopardizing what they now have under Obamacare. In fact, a nonpartisan poll in December (see Figure 7) showed that 75% of Americans felt Congress should not repeal the ACA or should at least delay its repeal until the details of a replacement plan are made public.

This week alone, Senators Susan Collins (ME) and Bill Cassidy (LA) offered a proposal for replacing the ACA, and Senator Rand Paul (KY) unveiled a plan of his own. Neither approach would fully safeguard children’s dental coverage as it now stands nor provide the range of affordability protections that current law ensures. In a follow-up blog article, CDHP will explore those two proposals and provide more details on why each of these replacements would fall short.

It is really important to educate your members of Congress about the importance of sustaining robust, affordable oral health coverage for families.

Needless to say, the process for repealing ACA is complex and daunting. But your voice really matters! It is really important to educate your members of Congress about the importance of sustaining robust, affordable oral health coverage for families.

Newly released data show that under the ACA, average monthly premiums for children’s dental coverage have fallen over the last three years. We would hate to see any replacement for the law that would reverse this progress toward making dental coverage more affordable for families.

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Did you know?

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Children with poor oral health were nearly 3x more likely to miss school due to dental pain.
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