Update: 1/11/2017, 9:30 PM: By a 51-48 vote, the U.S. Senate passed a budget resolution that is to serve as a vehicle to repeal the ACA, with a target date of January 27. Both Alaska’s senators voted in support, according to The Hill. The House is scheduled to vote on the measure Friday. The budge resolution grants jurisdiction to committees to begin writing the repeal legislation.
President-elect Donald Trump made the repeal and replacement of the Affordable Care Act (ACA), President Barack Obama’s signature piece of legislation, a dominant plank of his campaign.
“Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act — Obamacare,” his campaign website offers. “On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.”
Wednesday morning, in his first press conference since winning in the November election, he returned to that theme, announcing that once his pick for Secretary of U.S. Health and Human Services — Rep. Tom Price (R-Georgia) — is confirmed, he will submit a plan to repeal and replace the ACA.
“It will be essentially simultaneously,” he added. “It will be various segments, you understand, but will most likely be the same on the same day or the same week, but probably the same day. It could be the same hour.”
“We’re going to get health care taken care of in this country.”
The new timeline throws a wrench into House Speaker Paul Ryan’s (R-Wisconsin) plans. Since signed into law in March of 2010, the ACA has brought coverage to 20 million previously uninsured Americans. Almost seven years later, the policy has become entrenched in the U.S. health care system, with most of the newly insured brought into the fold not enthused about the prospect of losing it.
Ryan, last month, discussed a plan with Vice President-elect Mike Pence to first repeal the ACA, but then allow for a phasing out of it that could span several years, according to The New York Times.
But the first part of those two-pronged plans — either “repeal and replace” or “repeal and delay” — is meeting growing opposition from both sides of the aisle. That’s important, because the proposed “repeal” portion (currently taking the form of dozens of separate bills rescinding different parts of the ACA, being voted on in the U.S. House at present) contains non-budgetary measures that would need a 60-vote threshold in the Senate — meaning Republicans would need to hold all 54 GOP senators’ votes and pick up those of six Democrats.
Some estimates put the number of possible Republican defectors at nine, meaning they wouldn’t even reach a simple majority. Republicans, including senators Rand Paul (Kentucky), Tom Cotton (Arkansas), Bob Corker (Tennessee), Susan Collins (Maine), and Lisa Murkowski (R-Alaska), are asking that a plan be in place before a repeal vote.
On Monday, Murkowski was one of five GOP senators introduced an amendment that would delay a deadline for committees jurisdiction to write repeal legislation from January 27 to March 3. That amendment was blocked.
“Congress is poised to make good on the commitment of fixing the failures imposed on Alaskans and Americans across the nation by the Affordable Care Act,” Murkowski said in a press release last week. “Know that I will work with Alaskans to deliver a better system that addresses many of our state’s unique healthcare challenges.”
I have heard from many of you who have weighed in on the issue by contacting my office, either by phone or e-mail. I recognize that there is uncertainty right now as to what the repeal and replace plan will ultimately look like, and I appreciate everyone who has shared their concerns with me.
New polling gives us a better idea of the public feedback Alaska’s senior senator has been receiving.
The Alliance for Healthcare Security (AHS) is a national coalition of nurses, caregivers, patients, and health care advocates, who describe their efforts as “working to educate consumers and families on the importance of the Affordable Care Act.” The Alaska chapter of the pro-ACA coalition contracted Public Policy Polling (PPP) to gauge the public’s views on the Affordable Care Act and the implications of its repeal.
“An overwhelming majority of Alaskans believe it is wrong to repeal without a plan to replace the ACA, including how to lower costs, keep people covered and protect people with pre-existing conditions,” AHS wrote in their findings. “New research shows 77 Percent of Alaskans want plan before repeal.”
66 percent of Alaskans strongly or somewhat oppose cutting off funds for Planned Parenthood. These healthcare centers provide birth control, cancer screenings, and other preventative care to millions of women.
81 percent of Alaskans strongly oppose allowing companies to deny coverage for preexisting conditions.
78 percent oppose eliminating provisions that provide routine check-ups for people who need them the most, which includes cancer screenings and mammograms and wellness checks for children.
62 percent opposed elimination funding for health coverage that will result in almost 30 million American losing their health insurance, including 4 million children.
66 percent strongly oppose and 10 percent somewhat oppose the provision that would further eliminate tax credits that help low and moderate income people buy their own coverage and increasing their taxes by $3800 per year.
Additionally, 62 percent of Alaskans said that Congress should keep “what works” in the ACA and fix what doesn’t, compared to 22 percent who prefer to scrap it and start over with a new legislation.
Even along party lines, there is palpable support. 76 percent of Republicans polled oppose reducing coverage protections for preexisting conditions; 82 percent oppose charging older people more for insurance; 55 percent oppose the prospect of the newly insured losing their coverage; 66 percent want Congress to release an alternative plan. Conversely, 51 percent of Republicans polled support cutting funding of Planned Parenthood.
PPP surveyed a sample size of 1,143 Alaska voters between January 5-7 — 80 percent responded via phone and 20 percent over the internet through an opt-in panel. Respondents identified as 17 percent Democratic voters, 31 percent Republican voters, and 52 percent independent, in line with statewide demographics. 53 percent were women and 47 percent were men.
Sen. Dan Sullivan (R-Alaska) has maintained his support of “repeal and replace,” citing the high premiums and deductibles, but has not indicated whether or not he would support “repeal and delay.”
“For the sake of millions of Americans who have been misled, we can’t afford to wait for Obamacare to self-destruct. Providing affordable health care for all Americans is a very important goal, but Obamacare isn’t even succeeding at that,” he wrote in a December press release. “It’s imperative that we repeal this law and replace it with one that includes tort reform, enables interstate competition, allows small business the same healthcare tax deductions as big business, is transparent so people know what they are buying and ensures people with pre-existing conditions get covered.”
So far, there have been no comprehensive health care replacement plans filed in Congress this year.