Here We Go Again! No Vote On ACA Repeal

By Susan Rupe

It could almost be called a case of "deja vu all over again."

Another attempt to replace the Affordable Care Act died on the vine when Senate Republican leaders decided Tuesday afternoon not to bring the Graham-Cassidy bill to a vote. The bill, sponsored by Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., was a last-ditch effort to kill off the ACA. Under the Graham-Cassidy bill, the insurance subsidy program and Medicaid expansion program that were created under the ACA would be dismantled and instead would be converted into block grants to states.

Republicans had a thin margin of error to get the bill passed, and with four GOP senators coming out publicly against the measure, it was nearly impossible to get enough votes to pass it.

Opposition to the bill came from Sens. John McCain, R-Ariz.; Susan Collins, R-Maine; Rand Paul, R-Ky., and Ted Cruz, R-Texas. No Democrats would support it.

Senate Republicans that they will continue to work on health-care reform, even though they will likely miss the Sept. 30 deadline for the special reconciliation bill that would allow them to pass legislation with a simple majority vote.

Two organizations representing the health insurance agent community expressed their own misgivings about the most recent efforts to reform health care.

The National Association of Health Underwriters said it could not support Graham-Cassidy, taking special exception to the bill's proposal to move much of the Affordable Care Act from the federal government to the states.

"The proposed legislation is likely to have untended consequences including a larger number of uninsured individuals, without actually taking the steps needed to stabilize the individual health insurance market," NAHU said in a statement released Tuesday.

"The new plan would redirect ACA funds back to the states as block grants allowing states broad authority to determine how to apply these funds in the states. To that end, states could take actions that would eliminate important consumer protections as well as go far beyond ACA requirements, such as adopting single-payer or a public option for one or more markets.

"Furthermore, establishing 51 completely different versions of health care systems in the states and District of Columbia could not only eliminate provisions that protect consumers but could also cause an enormous compliance burden for employers attempting to navigate the various health systems and their corresponding regulations and requirements."

Health Agents for America expressed their gratitude to Cassidy for attempting a last-ditch effort at health care reform, but added in a statement that "nothing has been done to address the cost of health care, the cost of prescription drugs, the fact premiums for individuals or employers/employees will be unaffordable, and agents and brokers are barely compensated for their hard work."

With a second high profile failure of health care in two months, "it appears that the president and congressional leadership are ready to move on to tax reform and other issues in the short term," said HAFA's senior vice president Michael Keegan.

"The question now is whether the GOP wants to continue pushing repeal, or can the party support legislation that addresses problems with the law, and what their base will accept after seven years and four election cycles of promises to repeal the ACA?"

Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., held a series of hearings earlier this month to begin the process of crafting bipartisan legislation to stabilize the individual insurance market. That effort was stalled during the run-up to a possible Graham-Cassidy floor vote. Keegan wondered whether that could become the legislative vehicle to address issues like rising premiums or insurers exiting the insurance marketplaces.

"The bill is not as comprehensive as earlier repeal proposals, and comes too late for 2018 as insurers have to file rates for plans on the insurance exchanges by September 27, but it could be a starting point going forward," he said.

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 [email protected].