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Watchdog Task Force Update 07/21/2017

Friday, July 21, 2017   (0 Comments)
Posted by: Sheri Ryan
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There has been a great deal of activity in the last two weeks as the Trump Administration and Congressional Republicans push to “repeal and replace” the Patient Protection and Affordable Care Act (ACA), commonly known as “Obamacare.”

Last week, Senate Majority Leader Mitch McConnell (R-Kentucky) announced that there would be a vote this week on the “Better Care Act,” the Senate’s version of repeal and replace. Needing 50 votes from his 52-member caucus, two senators – Rand Paul of Kentucky and Susan Collins of Maine – almost immediately announced that they would oppose opening debate on the bill.

On Saturday, Senator John McCain of Arizona underwent emergency surgery for a blood clot. McConnell then announced that the Senate would “defer consideration of the Better Care Act” while Senator McCain recovers. Then, on Monday, two additional Senate Republicans – Mike Lee of Utah and Jerry Moran of Kansas – declared their opposition. According to media reports, another six moderate Senate Republicans were undecided.

McConnell conceded Monday night that “the effort to repeal and immediately replace the failure of Obamacare will not be successful” and outlined plans to vote on a measure to straight-out repeal the Affordable Care Act, with a two-year delay in which they would come up with a plan to replace it.

After the announcement, President Trump Tweeted: “Republicans should just REPEAL failing Obamacare now & work on a new Healthcare Plan that will start from a clean slate. Dems will join in!”

However, Senators Shelly Moore Capito of West Virginia, Lisa Murkowski of Alaska, Rob Portman of Ohio, and Collins announced they would not support a straight repeal, citing concerns of an estimated 32 million more uninsured and the potential to “blow up” insurance markets across the nation.

On Tuesday night, McConnell announced that the vote to begin the straight repeal of Obamacare debate will occur next week, at the request of President Trump.

Wednesday, President Trump told Senate Republicans that they should not leave Washington, DC, for the August recess without repealing and replacing Obamacare. Majority Leader McConnell then said senators will take a procedural vote on health care next week. But, he was not clear on which measure would be debated: straight repeal or the Better Care Act.

By mid-afternoon, Politico was reporting that a group of Senate Republicans who opposed earlier plans to repeal and replace Obamacare would meet Wednesday night to try to hash out their differences.

Also in the past week, President Trump has sent mixed signals about how he would like the Senate to proceed: from a simultaneous repeal and replace, to a repeal first replace later, to no action at all in the hopes that Obamacare would collapse on its own. As of Wednesday, however, he was clear that he favored repeal and replace.

McConnell himself said there are two options: repeal and replace immediately, and repeal now, replace later. He said the former approach is “preferred,” but without a compromise on a replacement, "there is a large majority in our conference that want to demonstrate to the American people that they intend to keep the commitment they made in four straight elections to repeal Obamacare."

Obamacare Repeal and Reconciliation Act of 2017
Late Wednesday, Senate Republicans released a bill to repeal Obamacare without a replacement – the Obamacare Repeal and Reconciliation Act (ORRA). The bill would put a “sunset” on major provisions of the health law in 2020, including both funding of the Medicaid expansion and tax credits to purchase insurance on Obamacare markets.

The Congressional Budget Office (CBO) estimates that if the bill were to become law:

  • 32 million fewer people would have health insurance by 2026 than would if Obamacare remained in effect (17 million in 2018, 27 million by 2020, after the elimination of the ACA’s expansion of eligibility for Medicaid and the elimination of subsidies for insurance purchased through the marketplaces established by the ACA
  • Insurance premiums would increase by 25 percent in 2018 and double by 2026
  • Half of the US population would live in areas that would not have health plans available on the individual market by 2020
  • The federal deficit would be reduced by $473 billion over the next 10 years

However, some key Obamacare provisions, including protections for those with preexisting conditions and allowing children up to age 26 to remain on their parents’ coverage, will stay in law, because they cannot be repealed through the reconciliation process, which Senate Republicans must use to try and pass the bill with a 50-vote majority and avoid a filibuster. In reconciliation, provisions that are regulatory and have no impact on the budget cannot be passed through reconciliation.

Section 2706: Since provisions that are regulatory and have no impact on the budget cannot be passed through reconciliation, Section 2706, “Nondiscrimination in Health Care,” would presumably remain in law. Section 2706 reads:

“A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.”

For More Information

The Task Force has also been communicating with the American Chiropractic Association in our efforts to keep you regularly updated. We will continue to monitor the situation and share the information with you.



Dr. Dan Spencer- CHAIR- COCSA 1st Vice President

Dr. Don Cross- COCSA President
Kris Dowell- COCSA Secretary and Executive Director- MAC
John Murray- Executive Director- WCA
Tiffany Stevens- Executive Director- TCA
Dr. Brenda Holland- COCSA 2nd Vice President
Dr. John LaMonica- COCSA Past President
Dr. Art LeVine- Florida COCSA Representative

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