(This story was updated at 7 a.m. ET.)
As Congress returns Monday from the short holiday break, senators will continue efforts to get a bill on the president's desk that would repeal key parts of the Affordable Care Act, despite technical and political difficulties and a certain veto.
Republican senators had a plan to fast-track the bill that has passed through the House with the budget reconciliation process. But the parliamentarian ruled the bill would not have a direct enough budget impact for that method. This ruling indicates the bill needs 60 votes to pass the Senate, instead of a simple majority.
Senate Republicans this week scheduled a conference meeting for Monday evening with the idea of presenting a new version of their bill, which would roll back or eliminate the ACA's exchange subsidies and Medicaid expansion, by Dec. 2.
They indicated the bill would be changed enough to get approval from the parliamentarian for using the reconciliation process.
The House bill repeals the ACA's individual and employer health insurance mandates as well as the medical-device tax and the “Cadillac” tax on high-end insurance plans. It would also reduce funding for public-health measures.
These measures would likely be retained in the Senate bill.
Edwin Park, vice president for health policy at the left-leaning Center on Budget and Policy Priorities, said Senate leaders have talked about getting around the ruling by having the bill zero out penalties for those who do not get insurance instead of complete repeal.
“Otherwise those two provisions would have to be struck,” he said.
Senate Majority Leader Mitch McConnell has said he is determined to get the bill in front of President Barack Obama, who has said unequivocally that he would veto it. Other attempts at repealing the Affordable Care Act have stalled in Congress.
Three GOP senators, including presidential candidates Marco Rubio of Florida and Ted Cruz of Texas, have said they would not support the bill because it does not go far enough in repealing the ACA. On the other side, a few more centrist Republican senators have wavered on support for the bill because of provisions that would defund Planned Parenthood. They could also be pushed further away by the idea of restricting coverage options for people with lower incomes.
Park said the reconciliation attempt could be further complicated by the Dec. 11 deadline for a budget agreement, but it could also be pushed to be resolved later.
“This could be postponed to January or beyond,” he said.
