With insufficient support to garner the needed 51 votes for approval despite last minute revisions, the Senate did not take up a bill developed by Senators Graham (R-SC) and Cassidy(R-LA)to repeal portions of the Affordable Care Act (ACA) last week. The measure would have expanded the ability of states to seek waivers from the ACA’s rating and benefit requirements, eliminated the individual and employer mandates requiring individuals to have coverage and employer to offer coverage to employees, and make major changes to the ways in which state Medicaid programs are funded.
Negotiations between the Republican and Democratic leaders of the Senate Health, Education, Labor and Pensions (HELP) Committee on how best to stabilize individual insurance markets that were underway since the last unsuccessful repeal effort have resumed. Remarks made by HELP Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) have indicated that they believethey are near to reaching an agreement. Experts believe that such an agreement would likely allow states some additional leeway on waivers while limiting their ability to override certain ACA rating and benefit requirements.
The outlook for passage of an agreement is uncertain since any proposal will require 60 votes to pass the Senate, since the reconciliation rules that allowed for a simple majority expired on Saturday, October 30th. As Chairman Alexander has noted: "We need to get a significant number of Democrats, a significant number of Republicans . . . and then we've got a matter of eventually persuading the entire Senate, the House of Representatives and the President, so we're taking it a step at a time."