July 28, 2017 — Senate Majority Leader Mitch McConnell (R-Ky.) announced that the chamber will be moving on to other priorities after the latest version of Affordable Care Act (ACA) repeal-and-replace legislation was defeated by a narrow 51-49 vote early Friday. Republican Senators John McCain (Ariz.), Susan Collins (Maine) and Lisa Murkowski (Alaska) joined all Democrats and the two independents in opposition to the Health Care Freedom Act, which would have eliminated the ACA’s mandates on individuals and employers to buy health insurance, and would have also repealed the medical device tax.
Senate Republicans brought numerous versions of the bill to a vote this week after the chamber voted to open debate on Monday. The first version was a full repeal-and-replace of the ACA (also known as Obamacare), which included a gradual scaleback of the Medicaid expansion enacted under the ACA. That bill would also have allowed insurance providers to sell stripped-down plans that did not comply with ACA requirements as long as they offered at least one policy that did. It would have allotted $70 billion for states to help consumers with paying out-of-pocket healthcare costs in the form of cost-sharing or health savings accounts.
The repeal-and-replace process has been mired by disagreements within the Republican party between moderates and its more conservative members. With the failure of this and subsequent similar legislation, McConnell and Republican leadership introduced the so-called “skinny repeal,” which would have only repealed a relatively small portion of Obamacare requirements, in the hopes of garnering more support. An estimate from the Congressional Budget Office projected the bill would have increased the number of people who are uninsured by 15 million in 2018 compared to current law, according to the New York Times. The skinny repeal would have also increased insurance premiums about 20 percent.
In addition to the coverage mandates and device tax, the skinny repeal would also have made it easier for states to ignore federal mandates for insurance providers to offer a minimum set of benefits in their plans.