With the constant and rapid developments around the Affordable Care Act and the health care system, it is easy to feel completely lost. The Florida Consumer Health Alliance will begin providing regular updates about where we are and what we can expect next.
Last month, both chambers in Congress passed a budget bill instructing two House committees—Ways & Means and Energy & Commerce- to create the actual language of a budget reconciliation bill that would effectively eliminate the ACA. Although the House committees are tasked with drafting the actual language in the budget reconciliation package, in reality, the Trump Administration and House and Senate leadership will agree on the contents together. The House is expected to send draft language to the Congressional Budget Office (CBO) by the end of this week. The CBO will analyze the proposed language, estimate the cost, and will likely analyze it will impact the uninsured rate.
Meanwhile, Ways & Means and Energy & Commerce will be holding hearings to discuss potential components of the reconciliation package. These hearings provide members the opportunity to vet their partial replace ideas. Any “replacement” plan is likely to contain proposals to expand health savings accounts, establish high risk pools, enact per capita caps in Medicaid, and make changes to tax credits for purchasing private insurance.
The House hopes to begin moving the reconciliation package through the committee process during the first week in March. Once the House committees have voted on the legislation, the bill will move to the House floor for a vote. The House will then send the legislation to the Senate. Typically the Senate would then put the House language through its own committee process. The agreed upon bill would then go to the floor. At that point, Senate rules require 20 hours of debate before a vote. Only 51 votes are required to pass budget reconciliation in the Senate.
Moving the legislation through the House and Senate is expected to take three to four weeks. If Congress is able to meet this timeline, the budget reconciliation legislation will be sent to President Trump by late March or early April. However, as we have seen the timeline is proving to be extremely fluid and much is still uncertain.