114th Congress, Vote 58; House of Representatives #596

To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010, and for other purposes

Official Title: To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010, and for other purposes.

HR 596: The 56th Vote To Repeal Obamacare
Passed by the House February 2, 2015, 239-186 (8 abstaining).

Synopsis: This bill would repeal the Patient Protection and Affordable Care Act (ACA, or Obamacare), effective 180 days after the repeal bill is enacted. It also includes provisions to create a replacement for Obamacare, but it doesn’t specify any details about the replacement legislation beyond broad goals for what it would accomplish. Although it’s the 56th vote to repeal at least some portion of the ACA, it’s only the fourth vote to fully repeal the law.

The ACA was passed in March 2010, with the intention of making health insurance and healthcare more accessible and affordable. The Congressional Budget Office projects that from 2016 to 2025, the annual uninsured population in the US will still number about 30 million people, but that’s about 25 million fewer than there would have been if the ACA hadn’t been enacted.

The bulk of the law had been implemented by 2014. As of February 2015, more than 19 million people had enrolled in ACA-compliant individual plans (about 11.6 million in the state and federally run exchanges, plus about 8 million more who had enrolled directly in individual plans). And Medicaid/CHIP enrollment nearly 10 million people between September 2013 and October 2014.

Under the ACA, all new small group and individual plans &ndash including those sold outside the exchange &ndash must comply with a variety of consumer protection rules. Preventive care is covered at no charge to the enrollee, and there’s a cap on out-of-pocket charges. Essential health benefits must be covered with no annual or lifetime benefit maximums, and medical history is no longer used to set premiums or determine eligibility for coverage; pre-existing conditions are covered on all new plans.

Because the ACA includes premium and cost-sharing subsidies for low and middle-income enrollees in the exchanges, coverage is more affordable than it used to be for people with incomes under 400 percent of the poverty level.

When the House of Representatives voted to repeal Obamacare on February 3, Speaker Senate Minority leader John Boehner noted that it was a chance for the new freshmen to get their votes on the record in opposition to Obamacare.

Although the votes were split mainly along party lines, there were three House Republicans who voted against repealing the ACA: Robert Dold (Illinois), John Katko (New York), and Bruce Poliquin (Maine). All three have stated that while they don’t support the ACA, they did not believe that repealing it was the best course of action.

Why supporters pushed for this bill

• Boehner noted that with a new group of incoming freshman Representatives, many of whom had campaigned on promises to repeal the ACA, it was imperative that they be given a chance to officially cast their votes against Obamacare; 41 of them did so.
• ACA opponents believe that the law has increased health insurance premiums, restricted access to doctors through narrower provider networks, and limited personal freedom via the individual mandate. They also see the subsidies and Medicaid expansion as a form of wealth redistribution, which many of them oppose.
• ACA opponents also believe that the law is a burden on employers and will result in fewer jobs and fewer hours for workers.

Why opponents tried to stop the bill

• The Congressional Budget Office and the Joint Committee on Taxation estimated in 2012 that repealing the ACA would result in a $109 billion federal budget deficit over the decade spanning 2013 &ndash 2022. They continue to note that repealing the ACA would result in a budget deficit increase, but the CBO explained in 2014 that the financial ramifications of repealing the ACA become increasingly complex now that the majority of the law’s provisions have been implemented.
• Without the ACA’s guaranteed issue provision, millions of Americans who purchase their own individual health insurance would once again be subject to medical underwriting, meaning that people with pre-existing conditions would find it difficult, expensive, or impossible to obtain coverage.
• Without the ACA’s Medicaid expansion, premium subsidies, and cost-sharing subsidies, health insurance and healthcare would be unaffordable for millions of Americans. Nearly 10 million people are receiving premium subsidies through the exchanges as of February 2015, and about the same number are receiving free or very low-cost health insurance and healthcare as a result of Medicaid expansion.
• Repealing the ACA without a solid bipartisan replacement plan would leave health insurance carriers, medical providers and consumers in limbo, particularly now that most of the ACA’s provisions have be implemented. This was a big part of the reason that three Republicans &ndash all of whom oppose the ACA &ndash did not vote to repeal the ACA via HR 596.
• The bill faces a likely filibuster in the Senate, and certain veto if it reaches President Obama’s desk. Thus, many see it as a waste of taxpayer funds, especially given that it’s a fight that’s been playing on repeat for the last half-decade.

02/03/2015

Status: House passed

More: select a member to see his or her other key health care votes.