Tuesday afternoon Senate Majority Leader Mitch McConnell announced that they would not vote on Graham-Cassidy, effectively ending the GOP’s hopes of repealing and replacing the Affordable Care Act (ACA) this year. Graham-Cassidy, which was thought to be a non-starter just a couple of months ago, picked up significant steam in the last few weeks as GOP lawmakers faced the reality of their time to repeal and replace the ACA running out. Time was short because the Senate Parliamentarian ruled that the current push to repeal and replace with a simple majority (a process called budget reconciliation) had to end with the current fiscal year on September 30. With this short window of time, Graham and Cassidy pushed hard to get their bill to the floor for a vote and GOP leadership worked with the Congressional Budget Office (CBO) to fast-track a score on the bill (a requirement under budget reconciliation).
Even with the compressed time frame and energy behind the push, similar to the last attempt in July, the GOP simply couldn’t get it over the hump. This time they were unable to even bring the bill to the floor for a vote. The three Senators that effectively killed this bill were Rand Paul, Susan Collins and John McCain, who put the final nail in the coffin of the previous repeal and replacement attempt in July. All three had different grievances with the bill: Paul felt that it retained too many taxes and regulations of the ACA, McCain simply wanted the process to look more like “regular order” and Collins has never been comfortable with the various cuts in any of the GOP repeal and replacement attempts.
While the GOP attempt to repeal and replace the ACA seems dead for now, there is already talk of reviving the attempts in the not too distant future. This could be done by providing reconciliation instructions in either the 2018 or 2019 budget resolutions for health care (along with tax reform at some point) that would unlock the budget reconciliation option and the simple majority requirement again. Senators Lindsay Graham and Ron Johnson, who sit on the tax committee, have both already stated that if they were not able to pass a repeal/replace bill before the deadline of September 30, they will not vote for a budget unless it includes reconciliation instructions for healthcare reform and tax reform
We will continue to keep our ear to the ground and keep you posted on all things healthcare reform in the coming months.