Republicans in the U.S. House of Representatives passed a budget reconciliation bill Friday that initiates a swift process to repeal the Affordable Care Act.
The ACA — commonly known as Obamacare — has been a rhetorical punching bag for the right-wing since its inception. Throughout President Barack Obama’s tenure, the Republican-controlled House voted dozens of times to repeal the law, only to be blocked by Obama.
But with both chambers of Congress now controlled by Republicans and Donald Trump set to be inaugurated in one week, Republicans finally have the political power to scrap the act.
“My colleagues, this experiment has failed. This law is collapsing as we speak,” Republican House Speaker Paul Ryan said in a floor speech Friday. “And we have to step in before things get even worse.”
The bill easily passed out of the Republican-controlled House chamber, 227-198. Every Democrat who cast a vote opposed the measure, including Vermont’s sole member, U.S. Rep. Welch. Nine Republicans broke rank to vote against repeal.
In a floor speech shortly before the Friday vote, Welch accused Republicans of unfairly attacking the law without offering a comprehensive replacement plan.
“You’ve got some responsibility to show us the beef,” Welch said. “Where is the plan?”
He then gestured to a stack of documents Republicans had brought to the floor which showcased various conservative health care proposals offered in recent years.
“Now there’s a lot of paper over there, but you haven’t shown us a plan and here’s why,” Welch continued. “Because when you put pen to paper, all hell is going to break loose on your side, because you have to move beyond the rhetoric to figuring out how you’re going to pay to keep our kids on our healthcare plan, you’re going to have to figure out how to pay if we’re going to let folks with pre-existing conditions have health care. Those don’t solve themselves, and you don’t have a plan.”
The legislation — Senate Concurrent Resolution 3 — came to the House a day after it passed the Senate. Republicans hold a slim majority in the Senate, and the resolution was approved by a thin margin in that body, 51-48.
Vermont Sens. Bernie Sanders and Patrick Leahy both opposed the measure in the Senate.
The bill initiates the arcane budget reconciliation process, and does not actually repeal the Affordable Care Act. It instead lays the groundwork for rolling back the law by mandating that the House and Senate committees that oversee health care draft major cost-cutting measures — essentially a repeal bill — to be submitted to the House and Senate budget committees by Jan. 27.
Because the legislation only lays out a non-binding budget blueprint, it does not require ratification by Obama, who would oppose any effort to scale back one of his signature achievements.
Reconciliation legislation is also immune to the Senate filibuster. Republicans were able pass it out of the chamber with a simple majority, as opposed to the 60 votes normally required. The GOP holds 54 Senate seats.
Once the detailed repeal bill is written, Republicans can also steer it through the budget reconciliation process as long as the measures in the bill pertain to federal spending and revenues.
Potential measures in the bill could, for example, cut current health care subsidies offered through Obamacare, as well as the Medicaid expansion dollars budgeted in the law.
Budget reconciliation could also be used to eliminate taxes that were established by the ACA, like the 0.9 percent Medicare expansion tax currently levied on families that make more than $250,000 a year.
While much can be accomplished through budget reconciliation, any comprehensive replacement plan would have to be pushed through the normal congressional process. Therefore, a replacement bill will require 60 votes to pass out of the Senate, meaning that a handful of Democrats would have to come on board.
Republican leaders are promising to introduce a detailed repeal and replace plan in the near future, which is expected to be supported and signed into law by incoming Republican president Donald Trump.