Vote-A-Rama Coming On Health Care Bill

By Susan Rupe

Senate Republicans continue their bid to dismantle the Affordable Care Act (ACA) by considering an array of health care measures in the hope that they can get enough votes to pass one of them.

It starts out with 20 hours of debate, followed by an all-night “vote-a-rama” in which dozens – or even hundreds – of amendment votes will be taken.

Republicans are using a fast-track Senate procedure known as reconciliation. This process can avoid a filibuster by Democrats and allow a final bill to pass with as few as 50 votes. But strict Senate rules mean a number of provisions Republicans are seeking could be challenged successfully by Democrats, based on early guidance from the Senate parliamentarian.

So what will Senate Republicans be voting on? Here’s a look at some of the options.

Repeal and Replace – This plan would repeal most of the ACA. It would be replaced with a program of more limited subsidies to help people buy insurance. It also would roll back the ACA’s expansion of Medicaid. The Senate defeated a modified version of this plan Tuesday night in a 43-57 vote. The measure needed 60 votes to advance because it contained several provisions that violated the rules of reconciliation, according to the Senate parliamentarian.

The ‘Wraparound Amendment’ – Sen. Rob Portman, R-Ohio, proposed this amendment to help people who lose their Medicaid coverage move to private health insurance. It would also give states more flexibility to use federal dollars to help poor people who buy the private plans with out-of-pocket costs.

Full Repeal – This plan calls for a full repeal of the ACA, with a two-year delay so that lawmakers could craft a new program. This measure is expected to come for a vote Wednesday but is not expected to pass. The plan is similar to one Republicans passed in 2015, and that was vetoed by then-President Barack Obama. Trump has indicated that he would sign it.

‘Skinny’ Repeal – This proposal could end up being the fallback option for Republicans if they can’t decide on a more extensive repeal of the ACA. It would end the ACA’s individual mandate. It also would repeal a requirement that companies give coverage to their full-time workers. A repeal of the tax on medical devices could be included too.

Collins-Cassidy Plan - It would let each state decide whether to keep the ACA in place or run their own health insurance markets as they choose.

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at Susan.Rupe@innfeedback.com.

Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at susan.rupe@innfeedback.com.