112th Congress, Vote 460; House of Representatives #6079

Repeal of Obamacare Act

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 6079: Repeal of Obamacare Act
Passed by the House July 11, 2012, 244-185 (2 abstaining).

Synopsis: The ACA was enacted in 2010, and in the ensuing years Republicans in the House introduced numerous bills to repeal, defund, or delay portions of the law, or repeal the entire ACA. HR 6079 was one of several bills intended to repeal the ACA almost entirely, although it was more in-depth than most of the other repeal bills.

HR 6079 differs slightly from other full repeal bills in that it excludes one small subsection of section 1899A of the Social Security Act. This subsection refers to Congressional oversight of the IPAB (Independent Payment Advisory Board) and it's left intact under HR 6079 in order to avoid litigation. But lawmakers explained that it would be a moot point, since HR 6079 repeals everything else about the IPAB, so the panel would no longer exist if the legislation were to pass (note that the IPAB's funding was sharply reduced in early 2014, and lawmakers in the 2015 session are considering a bill – S 141 – that would S 141 – that would dissolve the IBAP altogether).

The ACA includes provisions to reduce healthcare costs and improve patient outcomes, along with a wide range of insurance industry reforms designed to protect consumers and improve access to care. Under the ACA, health insurance sold in the individual market must be guaranteed issue as of January 2014, meaning that medical history can no longer be used to determine an applicant's eligibility or premium. In addition, all policies must cover a list of ten essential health benefits, and there can no longer be lifetime or annual benefit maximums. Carriers in the individual and small group markets must spend at least 80 percent of premium dollars on healthcare, and there are limits on how high out-of-pocket charges can be.

HR 6079 calls for repeal of the ACA, but it does not put forth any alternative proposals to bring about reform in the insurance and healthcare industries. It would essentially revert things to the way they were prior to 2010.

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

• HR 2 (2011)
• HR 45 (2013)
• HR 596 (2015)

Several nonbinding House budget measures have also included ACA repeal.

Why supporters pushed for this bill

• HR 6079 supporters believe that the healthcare system is better off with less government regulation, and this bill would remove a significant amount of regulation imposed by the ACA.
• The text of HR 6079 notes that President Obama promised people they could keep their health plan if they liked it, but notes that "millions of Americans" could lose their coverage as a result of the ACA.
• The bill also notes that individual health insurance premiums are expected to increase under the ACA, and will be $2,100 higher by 2016 than they would have been without the ACA (this is not in dispute, but it's important to note that these are "retail" premiums, before any exchange subsidies are applied; for people with incomes up to 400 percent of the federal poverty level, tax credits are available under the ACA to significantly offset the cost of coverage).
• The ACA includes reforms to the Medicare Advantage market that were expected to result in fewer enrollees in Medicare Advantage plans. This was seen by some senior advocates as a detriment to beneficiaries (this hasn't come to pass however – Medicare Advantage enrollment has continued to climb since the passage of the ACA).
• Obamacare opponents view the ACA as problematic for the economy and the job market; the text of the law says that the ACA is "causing great uncertainty, slowing economic growth, and limiting hiring opportunities." Thus supporters of HR 6079 believed that it would improve the country's economic outlook.

Why opponents tried to stop the bill

• Repealing the ACA would be expensive. The Congressional Budget Office (CBO) projected that HR 6079 would increase federal budget deficits by $109 billion over the decade from 2013 to 2022.
• In addition, the CBO projected that under HR 6079, there would be about 60 million uninsured nonelderly people in the US by 2022, as opposed to 30 million if the ACA were left intact. This is due to a combination of reduced Medicaid eligibility, the elimination of premium subsidies that make private coverage more affordable, and also the elimination of the ACA's individual and employer mandates.
• The Leadership Conference on Civil and Human Rights expressed strong opposition to HR 6079, noting that "the ACA is vital to improving the health of our nation's most underserved communities-including low-income families, people of color, women, seniors, and people with disabilities." If HR 6079 were to be enacted, health insurance coverage for millions of Americans – including some of the most vulnerable populations – would be jeopardized.
• The CBO noted that enacting HR 6079 would be complicated because it had already been 2.5 years since passage of the ACA, and several aspects of the law had already been implemented. HR 6079 does not specifically say how it would reverse these portions of the law.

07/11/2012

Status: House passed

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