GOP ‘still has options’ after pulling ACA repeal bill

On March 24, Republican lawmakers pulled their proposal to undo parts of the Affordable Care Act (ACA) when it became clear they didn’t have the necessary votes to pass the bill in the House.

The American Health Care Act would have, among other things, effectively voided the ACA’s employer mandate, which requires large employers to offer workers affordable health insurance. It also would have delayed the “Cadillac tax” on high-value health plans and made a few small changes to employer plans. Employers’ reporting requirements, however, generally would have remained. (For a full review of the bill’s provisions, see “ACA repeal proposal: Employer mandate gone, Cadillac tax remains.”)

Support for the bill dwindled as lawmakers tried to make concessions, according to Eric Schillinger, an associate at Trucker Huss and a contributor to Federal Employment Law Insider. Each time Republicans amended the bill to appease one group, they alienated another, creating a tug-of-war, he explained. Instead of allowing the bill to come up short on the House floor, Republicans pulled it to save face, he said.

Speaker of the House Paul Ryan (R-Wisconsin), speaking to reporters about the decision, said he told President Donald Trump they needed to pull the bill, and the president agreed. “We came really close today[,] but we came up short,” Ryan said. “We just didn’t quite get consensus today.”

Ryan said the setback wasn’t the end of the road for healthcare reform. However, “we’re going to be living with Obamacare for the foreseeable future,” he said.

Schillinger said Ryan’s comments may have been a bit hyperbolic, perhaps an attempt to galvanize support for future legislation or to save face. “I don’t buy that this is a sort of surrender,” Schillinger said. Even if they give up on taking the legislative route, Republicans still have a few options, he said. For example, federal agencies have some discretion in how they implement and enforce the ACA.

So even though the ACA remains “the law of the land” as Ryan said, there probably still will be plenty of changes in the next 12 months, Schillinger said. It’s just not clear what those changes will be.