The US House of Representatives on Friday struck the second blow in the repeal of the Affordable Care Act (ACA), better known as Obamacare.
The House passed a resolution Friday that will direct committees in the Senate to draft legislation that would repeal the ACA.
The resolution’s passage followed a morning of spirited debate, including a colourful goat analogy from one Republican lawmaker. But both parties largely stuck to their talking points: Republicans highlighted increasing premiums and costs, while Democrats focused on expanded coverage to more than 20 million Americans.
In the end the resolution passed 227 to 198, with nine Republicans and no Democrats crossing party lines.
“By taking this first step toward repealing Obamacare, we are closer to giving Americans relief from the problems this law has caused,” House Speaker Paul Ryan said in a statement. “Too many families have seen costs soar, quality drop, and choices reduced to one — which just isn’t a choice at all. This resolution gives us the tools we need for a step-by-step approach to fix these problems and put Americans back in control of their health care.”
The vote had a sliver bit of doubt after Sen. Rand Paul tried to bring together Republicans to reject the bill over concerns a repeal without a replacement would increase the federal deficit. Paul was the only Republican to vote against the resolution in the Senate.
Despite the wrangling by Paul, the march towards the repeal of Obamacare continues.
The process toward repeal is a bit complicated, so let’s break it down
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Republicans are using what is called budget reconciliation to repeal a large part of Obamacare.
Budget reconciliation allows lawmakers to pass legislation that has an effect on the federal budget with only a simple majority. In this case, outlays for things in the ACA, such as Medicaid expansion and funding for exchanges on which people can sign up for insurance, fit the bill.
Trying to pass a bill outside budget reconciliation would allow Democrats to filibuster any legislation. A filibuster can be quashed only with a cloture vote, which needs to be approved by 60 senators to pass. (The Senate includes only 52 Republicans.)
So where does the resolution passed by the House on Friday go next?
Relevant committees will convene over the next few weeks to begin the process of drafting a repeal bill.
From there, the drafting will go much like any other bill: to a vote on it in the House (subject to simple majority) and then on to the Senate, where it can be amended. If it is amended, then it goes to conference committee.
If the Senate adds amendments, the conference committee made up of both House and Senate members responsible for drafting the bill would come together and create a compromise bill. That bill would then go through votes in both bodies and, if passed, go to Trump’s desk for approval or veto.
Though the repeal is on the top of the legislative agenda, Trump is unlikely to put his pen into action on it anytime soon.
GOP leaders’ comments that they want to replace the bill at the same time they repeal it suggest that a seamless transition may take time. Ryan has said replacement and repeal would happen “concurrently,” and President-elect Donald Trump has pledged it will be “simultaneously.”