Late on the afternoon of Jan. 7, new House Speaker John Boehner (R-Ohio) applauded the House for passing a rule that allows for debate on Jan. 12 to repeal and replace the ACA. “Today, the House has taken the first steps towards repealing the job-killing healthcare law and replacing it with common-sense reforms that lower costs and protect jobs,” Boehner said in a statement.
A full House vote to repeal the bill, as well as the provisions of the Health Care and Education Reconciliation Act of 2010, which made some changes to the ACA, is scheduled for Jan. 12. Both the ACA and the reconciliation act were enacted in March 2010.
Also scheduled for Jan. 12 is a vote on Dreier's replacement resolution, which directs the House Education and the Workforce, Energy and Commerce, Judiciary, and Ways and Means committees to begin work on a bill that fosters economic growth and job creation, lowers healthcare premiums through greater competition and choice, expands incentives to encourage personal responsibility for healthcare costs, and eliminates duplicative government programs and wasteful spending.
Dreier led a 12-hour, sometimes contentious committee meeting to hear testimony from scores of witnesses about the potential to repeal and replace the ACA last week. During the committee meeting, and in his comments on the House floor Jan. 7, Dreier said Republicans will look for tangible alternatives and concrete proposals in replacing the bill. He highlighted some possibilities, such as the purchase of insurance across state lines, associated health plans, risk-pooling for pre-existing conditions, health savings accounts and meaningful lawsuit reform.
If the ACA stands, the nation would no longer be living under the powers of government enumerated in the Constitution, Rep. Steve King (R-Iowa) of the House Judiciary Committee said during his testimony at the Rules Committee hearing. “We would live instead under a regime.” King also referred to the health reform act as a “malignant tumor” that will metastasize if it's not abolished.
Boehner, Cantor and some House GOP committee chairmen released a report Jan. 6 that they said makes the case for repeal. Asserting that the ACA will cost the nation $2.6 trillion when it's fully implemented and add $701 billion to the deficit in the first 10 years, the report—Obamacare: A Budget-busting, Job-killing Health Care Law—cites a study from the National Federation of Independent Business that says an employer mandate alone could lead to the elimination of 1.6 million jobs between 2009 and 2014, with about 66% of those coming from small businesses.
The report from House leaders also highlighted the effects of the law's controversial 1099 provision, saying it will inevitably create higher compliance costs for small businesses. And additional job losses could come, the report said, from a 2.3% excise tax on medical device companies.
Outgoing House Speaker and new House Minority Leader Nancy Pelosi (D-Calif.) said Democrats will judge what comes before Congress by whether it creates jobs, strengthens the nation's middle class and reduces the deficit. A repeal, Pelosi said, fails all three of those tests.
“Republicans are rushing a bill to the floor that would repeal the rights of patients, including children with pre-existing conditions, pregnant women, young people on their parents' insurance and seniors,” Pelosi said in a written statement. “Doing so would put insurance companies back in charge of the health of the American people and, according to the nonpartisan CBO, add $230 billion to the deficit.”
The CBO report also estimated that under the repeal bill, about 32 million fewer non-elderly people would have health insurance in 2019, leaving a total of 54 million non-elderly people uninsured, while about 24 million people who would otherwise purchase their own coverage through insurance exchanges would not do so, and Medicaid and the Children's Health Insurance Program would have about 16 million fewer enrollees. In addition, the CBO estimated that enacting the repeal bill would increase federal budget deficits beyond 2019.
At the Rules Committee hearing last week, Rep. Jared Polis (D-Colo.) asked why there were no measures to offset the costs of the repeal bill, and asked witnesses representing the Education and the Workforce, Energy and Commerce, and Judiciary committees to have their respective committees identify those offsets.
“We're going to be looking in every department and agency for savings,” said Fred Upton (R-Mich.), incoming chairman of the Energy and Commerce Committee and one of the witnesses.
Some observers contended the repeal issue is largely symbolic, given that a repeal bill is unlikely to pass in a Democratic-controlled Senate. And even if the Senate does pass such a bill, President Barack Obama would veto it, and there are not enough votes in the Senate to override a veto, according to Randy Fenninger, Washington lobbyist for Physician Hospitals of America, the association that represents physician-owned hospitals.
“For the Republican leadership and rank-and-file, it's very important that they see concrete action,” Fenninger said about a repeal bill. “The real interesting part becomes: What next? You get into serious discussions, both from a philosophical and practical level,” Fenninger added. “And how you deal with the CBO numbers—that's not going to go away.”