114th Congress, Vote 329; Senate #3762

Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015

Official Title: To provide for reconciliation pursuant to section 2002 of the concurrent resolution on the budget for fiscal year 2016.

HR 3762: Budget reconciliation measure to repeal portions of the ACA
Passed by the Senate December 3, 2015, 52-47 (1 abstaining).

Synopsis: Rep.Tom Price (R-Georgia) introduced H.R. 3762 in the House on October 16, 2015. On October 23, it passed the House with a vote of 240 to 189. The Senate took up the bill in November, added additional provisions to make the repeal effort more robust, and passed their version of the bill on December 3, with a 52-47 vote.

Since the Senate passed a different version of the bill, it had to be be reconciled with the House before it was sent to President Obama. On January 6, 2016, the House passed the Senate's version of the bill, but President Obama vetoed it two days later. A vote to override the veto failed in the House on February 2.

The House version of H.R. 3762 included repealing the individual mandate, the employer mandate, the medical device excise tax, and the "Cadillac tax"" on expensive employee health insurance premiums.

It also included a measure to eliminate federal Medicaid funding for Planned Parenthood for one year. But it called for increasing funding for community health centers by $235 million/year for two years (a 6.5 percent increase over the currently scheduled funding).

Republicans used the budget reconciliation process to ensure that their bill could advance through the senate as long as it received a simple majority of at least 51 votes, instead of needing 60 votes. By using reconciliation, the measure was filibuster-proof, and advanced to a vote in the Senate. Although there have been more than 50 bills that attempted to repeal or defund all or part of the ACA over the years, H.R. 3762 marked the first time that Republicans have used reconciliation to push the legislation through with a simple majority in the Senate.

The Senate added six amendments to the bill, and made it a much more robust attempt at repealing the ACA. In addition to the House provisions, the Senate's version would have implemented a two year phase-out of Medicaid expansion and exchange subsidies.

The House agreed to the Senate's changes, so the final version of the bill included the Senate's modifications.

There were concerns in Congress – particularly among lawmakers from states that have expanded Medicaid – that repealing the law would result in millions of people losing their health insurance coverage. But Politico reported that "senators were reminded that the president would veto the repeal bill anyway, meaning Republicans could vote on the measure without having to deal with the political risks of actually making major changes to existing law."

Why supporters pushed for this bill

• Republicans in Congress have been outspoken in their opposition to the ACA for years. Support for H.R. 3762 fell nearly along party lines. In the Senate, the dissenting 47 votes came from 45 Democrats, with just two Republican joining them (Susan Collins of Maine, and Mark Kirk of Illinois).
• H.R. 3762 represented the first time that a major ACA repeal bill has been passed by both chambers of Congress (although the differences in the two versions must be resolved before the bill is sent to the President). H.R.3762 allowed Senate Republicans the opportunity to vote on a repeal measure and demonstrate to their constituents that they had done everything possible to repeal the ACA – despite the fact that they know President Obama will veto the bill.
• Republicans have long tried to defund Planned Parenthood, and H.R. 3762 gave them an opportunity to vote on that issue.
• The bill – and the use of budget reconciliation – allowed the full Congress to vote on repealing many controversial aspects of the ACA (particularly in the Senate version), but leadership clearly stated that lawmakers would not have to face repercussions due to people losing coverage, as the President would certainly veto the legislation.
• Despite the fact that the legislation was doomed to a veto from the start, the use of reconciliation – and the fact that the bill would indeed advance to the President's desk – was seen by some lawmakers as a victory. Prior to a vote on a Senate amendment to repeal the ACA earlier this year, Senator Ted Cruz (who is fiercely opposed to the ACA and supports repeal) had criticized the vote as "meaningless political theater" because it was clear that the amendment wouldn't garner the 60 votes needed to add it to the legislation. Cruz pushed instead for the use of reconciliation, because then only 51 votes would be needed. The use of reconciliation for H.R. 3762 meant that lawmakers could be virtually assured it would reach the President's desk.

Why opponents tried to stop the bill

• Democrats have long supported the ACA, and continue to reiterate the many ways that it's helping Americans, including an estimated 10 million people who have coverage through the ACA's exchanges, several million more who have ACA-compliant coverage purchased outside the exchanges, and nearly 14 million who have gained coverage under Medicaid.
• President Obama has promised to veto H.R. 3762 – and any other bills that call for repeal of the ACA. As such, the bill was seen by some as a waste of political time and money (particularly given that GOP leadership used the promised veto as a reason lawmakers should feel free to vote for repeal, knowing they wouldn't have to face the consequences of actually repealing the ACA and terminating coverage for millions of Americans). Senate Minority leader Harry Reid noted that "we're wasting our time here today [because the measure will be vetoed]."
• H.R. 3762 repeals major portions of the ACA, but not the entire thing. It would eliminate the individual mandate, but not the provision that requires guaranteed-issue coverage (ie, no medical underwriting to account for pre-existing conditions). Guaranteed-issue coverage without a mandate is doomed to fail.

Status: The President vetoed the bill on January 8, and the House failed to override the veto. The bill is now dead.

12/03/2015

Status: Senate bill passed

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