The House last week followed the Senate in passing a budget reconciliation bill aiming to repeal key pieces of the Affordable Care Act (ACA). As expected, President Obama quickly vetoed the legislation.
These developments were notable in that they marked the first presidential veto of Obamacare repeal legislation and the first use of the budget reconciliation process as a means to pursue repeal. The reconciliation process makes legislative action easier because it allows a simple majority to pass budget-related legislation without facing a filibuster.
However, use of the reconciliation process also limited the extent of attempted repeal, notably leaving in place insurance reforms and the mandate to purchase insurance — while eliminating the mandate’s penalties, subsidies to purchase insurance, and the taxes used to pay for those subsidies.
Under the legislation, the ACA’s Medicare reforms and provider-payment cuts would have remained in place. The resulting mix of pre- and post-ACA policies would have lead to increased dysfunction in the health care system.
The Congressional Budget Office estimated repeal would reduce the deficit by $318 billion over 10 years. Beyond that, the deficit reduction would likely diminish and eventually reverse. The budget office estimated repeal would increase the number of Americans without health insurance by about 16 million.
Estimates on ACA Repeal Legislation (CBO)