In early 2016, there were renewed efforts by House and Senate Republicans to pass a bill that would repeal the Affordable Care Act. While it does not roll back all of the law, major sections are struck, including the individual purchase mandate, insurance subsidies, the insurance exchanges, the prescription drug tax, the OTC medicine tax, and others. Over the past five years, House Republicans have passed multiple bills attempting to repeal the ACA, but this marks the first time such a measure has passed in the Senate.
After so many failed attempts, and a seemingly unchanged political gridlock, one may wonder how Congress was finally able to pull off a repeal in the House and Senate — the key is in the procedures. Using a complicated legislative process known as reconciliation, Congress can consider bills under specific rules that avoid a filibuster and can be passed with a simple majority. The Congressional Budget Office estimated the original legislation, if implemented, would reduce deficits by $474 billion over the next ten years. Following passage and presidential signing of the Consolidated Appropriations Act of 2016, however, the CBO revised its estimates in lieu of the two-year delay of the ACA’s Cadillac tax that was included in the budget package. The new figures report a deficit reduction of $516 billion over the same period.
What happened next?
President Obama vetoed the legislation, where the House failed to override with a two-thirds vote. Though the supermajority was not reached, the bill’s supporters see it as laying the foundation for future efforts in the years to come — when, potentially, the President’s desk would be a very different place for such a bill to land. While the road to responsible fiscal policy is still quite long ahead, it’s now clear how much is possible using the powerful reconciliation process.