Republicans Deeply Divided Over Repeal of the Affordable Care Act

Office of the Democratic Whip Steny H. Hoyer

January 10, 2017

Republicans Deeply Divided Over Repeal of the Affordable Care Act

For over six years, Senate and House Republicans have been promising the American people that they would repeal and replace the Affordable Care Act. Yet, now that they are days from voting on a budget resolution to begin the process of repealing the ACA, they still don't have a plan to replace it and are deeply divided over their path forward.

On Monday, the House Freedom Caucus - which nearly shut down the government over the ACA - voiced concerns about the process of repealing the ACA without a replacement:

Rep. Mark Meadows (R-NC): "We just need to slow down the process so that we can understand a little bit more of the specifics of the timetable, replacement votes, reconciliation instructions, etc." [The Hill, 1/9/17 ]

And in the Senate, there is a great deal of anxiety among many Senate Republicans over their leadership's plan to move ahead without a replacement:

Sen. Lisa Murkowski (R-AK): "I have great concerns that we inject a level of great uncertainty into an already uncertain environment if we don't give people a clear indication as to what will come once we repeal." [Washington Post, 1/9/17 ]

Sen. Lamar Alexander (R-TN): "We have to take each part of it and consider what it would take to create a new and better alternative and then begin to create that alternative and once it's available to the American people, then we can finally repeal Obamacare." [Talking Points Memo, 1/9/17 ]

Sen. Tom Cotton (R-AR): "It would not be the right path for us to repeal Obamacare without laying out a path forward." [New York Magazine, 1/9/17 ]

Sen. Rand Paul (R-KY): "We need to think through how we do this, and it's a huge mistake for Republicans if they do not vote for replacement on the same day as we vote for repeal." [Politico, 1/4/17 ]

Sen. Bob Corker (R-TN): "There's more and more concerns about not doing it simultaneously... You would think after six years we would have a pretty good sense of what we would like to do." [Politico, 1/9/17 ]

On Monday, five Republican Senators filed an amendment extending the deadline for the committees to write an ACA repeal bill from January 27 to March 3.

Sen. Susan Collins (R-ME): "By providing more time to come up with legislative solutions, we have a better opportunity to produce a thoughtful, workable replacement that ensures Americans have access to affordable, diverse insurance plans that meet their needs." [The Hill, 1/9/17 ]

Sen. Bob Corker (R-TN): "As President-elect Trump has stated, repeal and replace should take place simultaneously, and this amendment will give the incoming administration more time to outline its priorities... By extending the deadline for budget reconciliation instructions until March, Congress and the incoming administration will each have additional time to get the policy right." [Bloomberg, 1/10/17 ]

Republican efforts to repeal the ACA without a replacement would "Make America Sick Again" and harm millions of families across the United States. According to research from the House Committees on Energy & Commerce and Oversight & Government Reform Democrats: https://democrats-oversight.house.gov/sites/democrats.oversight.house.gov/files/documents/ACA%20state-by-state%20fact%20sheets%20FINAL.pdf

*20 million Americans who gained coverage since the ACA was enacted would lose their coverage.

*11.1 million individuals who purchased Marketplace coverage would lose their coverage if the exchanges are dismantled;

*9.4 million individuals who received financial assistance to purchase Marketplace coverage in 2016 are at risk of having coverage become unaffordable;

*14.1 million individuals who enrolled in Medicaid under the expansion would lose coverage;

*3.4 million children who gained coverage since the ACA was implemented would lose coverage; and

*2.3 million young adults able to stay on their parent's insurance thanks to the under-26 provision in the ACA would lose coverage.

*The roughly 52.2 million individuals with pre-existing health conditions in America could have their coverage rescinded or see their costs dramatically increased.

*5 million seniors who saw the cost of their prescription drugs decrease thanks to the ACA closing the "donut hole" coverage gap would see their costs increase drastically.

*137.7 million individuals with private insurance would lose access to preventive services without co-pays or deductibles.

In addition to these consequences, Republican efforts to repeal the ACA without a replacement will have a devastating impact on our economy and would increase the deficit:

*Repealing the ACA without a replacement will cost nearly 3 million jobs by 2021. [Milken Institute School of Public Health, 1/5/17 ]

*Repealing the ACA will add $350 billion to the deficit. [Committee for a Responsible Federal Budget, 1/4/17 ]

The conservative American Enterprise Institute opposes repealing the ACA without a replacement:

"We do not support this approach to repealing and replacing the ACA because it carries too much risk of unnecessary disruption to the existing insurance arrangements upon which many people are now relying to finance their health services, and because it is unlikely to produce a coherent reform of health care in the United States. The most likely end result of 'repeal and delay' would be less secure insurance for many Americans, procrastination by political leaders who will delay taking any proactive steps as long as possible, and ultimately no discernible movement toward a real marketplace for either insurance or medical services." [Joseph Antos and James Capretta, 1/3/17 ]

And the effort remains deeply unpopular among Americans:

*A majority of Americans don't support Republican efforts to repeal the Affordable Care Act without offering a replacement. [Washington Post, 1/6/17 ]

Democrats will continue to oppose Republican efforts to "Make America Sick Again," and we will work to protect the millions of families who have benefited from the patient protections and cost savings provided by the ACA.