Capitol Hill

The race to repeal

Repealing and replacing the Affordable Care Act (ACA) has been a central plank in the Republican platform since the law was passed in 2010. With Republicans now in control of the House, Senate and White House, the wheels are in motion to repeal the law and replace it with patient-centered, cost-reducing reforms.

Congress has started working toward repealing the ACA under a process known as "reconciliation" where only 51 votes are needed in the Senate to pass legislation deemed to reduce the budget deficit. The House only needs a simple majority, and there are plenty of Republican votes to pass a repeal bill. With this procedure, Republicans can pass a bill that repeals core components of the ACA without the support of Democrats just as Democrats used the reconciliation process to originally pass the ACA when they held the majority.

Four congressional committees have been instructed by the budget committees to craft legislation to repeal the ACA and target the financing mechanisms that fund it. Only provisions that affect the budget are eligible to be included in reconciliation.

A number of ACA taxes are expected to be included in the reconciliation repeal bill, including the Health Insurance Tax (HIT), which NRCA has long advocated for repeal. The HIT was authorized by the ACA as a funding source and has been estimated to increase premiums on small-business and individual health insurance plans anywhere from $250 to $500 per year. NRCA and allied groups were able to secure a one-year suspension of the tax for 2017, but inclusion of the HIT in the reconciliation bill would permanently repeal the tax.

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