113th Congress, Vote 154; House of Representatives #45

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

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.

HR 45: To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010.
Passed House May 16, 2013, 229-195 (9 abstaining).

Synopsis: Since the Affordable Care Act was enacted in 2010, a variety of bills have been introduced that would repeal all or part of the law, or defund or delay various aspects of it. HR 45 is among the most comprehensive of these bills, as it would repeal the ACA in its entirety.

HR 45 was introduced by MN Representative Michele Bachmann, who called herself "the champion of repealing Obamacare." Among the bills that Bachmann introduced during her time in the House, HR 45 was the only one that ever passed.

Similar bills that have called for full repeal of the ACA:

• HR 2 (2011)
• HR 6079 (2012)
• HR 596 (2015)
• Several House budget measures have also included ACA repeal, but they were nonbinding.

Why supporters pushed for this bill

• ACA opponents have been vocal from the beginning in their opposition to the law, and would prefer to see it erased from the books.
• HR 45 gave House Republicans an opportunity to go on record with their opposition to the ACA. This was particularly important for Representatives who had been elected after the ACA's passage. Although there was still widespread confusion regarding the ACA during the 2012 election cycle, there's no doubt that quite a few members of congress secured victories by capitalizing on their opposition to Obamacare; those members wanted to be able to prove to their constituents that they upheld their opposition to the ACA.
• Many Republican lawmakers champion alternatives to the ACA, although they tend to be vague and revolve around broad concepts like tort reform, buying insurance across state lines, tax credits or deductions to make coverage more affordable, enhanced Health Savings Accounts (HSAs), and better funding for high risk pools. Although tax credits are an integral part of the ACA, other aspects of Republican reform proposals (like enhanced HSAs and the purchase of coverage across state lines) were not included in the law. Some opponents of the ACA see full repeal as necessary in order to introduce their version of healthcare reform (other opponents have shown little interest in meaningful reform, and would presumably allow things to return to the way they were prior to 2010)

Why opponents tried to stop the bill

• Repealing the ACA would be expensive. In 2012, the Congressional Budget Office (CBO) estimated that repealing the ACA would result in "a net increase in budget deficits of $109 billion over the 2013-2022 period." That estimate was prepared as an analysis of HR 6079, a similar bill that had passed the House in 2012. Because the CBO had done an exhaustive analysis of the budgetary impact of repealing the ACA just 10 months earlier, the agency declined to conduct another analysis for HR 45. They noted that some of the ACA's provisions had already been implemented by 2013, but that overall, the impact would be similar to what they had calculated the year before – that is, a very costly venture.
• Repealing the ACA would return the private insurance market back to the way it was prior to 2010. This would be particularly problematic in the individual market, as there would no longer be a provision requiring coverage to be guaranteed issue starting in 2014, there would be no requirement that all plans cover the essential health benefits, there would be a return to lifetime and annual benefit maximums, and there would be no medical loss ratio requiring plans to spend the majority of premiums on healthcare.
• The bill – along with all of the other ACA-repeal bills – is generally considered symbolic, because the Senate won't pass it, and President Obama promised to veto it. Because of that, focusing on such bills is seen by some as a waste of lawmakers' time and taxpayers' dollars.
• House Democratic Whip Steny Hoyer (MD) noted that according to the NY Times, from 2011 to 2013, House Republicans had spent 15 percent of their time on the House floor attempting to repeal, defund, or delay all or part of the ACA. He characterized HR 45 as the continuation of a charade and a waste of time.

05/16/2013

Status: House passed

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