Graham-Cassidy bill dies: a timeline of Obamacare repeal efforts

By the numbers, there have been seven attempts to push through Affordable Care Act (ACA) repeal and replacement efforts in various forms and magnitudes since the inauguration of President Trump in January 2017. At some point, thirteen GOP senators voted against one or more of the repeal efforts. As of September 30, 2017, the 2017 budget reconciliation rules, allowing the GOP to pass a bill without being subject to a senate Democratic filibuster, expired. Although the effort is probably not over, there has been, to date, no successful repeal of the ACA (Obamacare).

Although there have been many versions of the repeal efforts, the two main plans so far have been the American Health Care Act (AHCA), introduced in March, and the Better Care Reconciliation Act (BCRA), introduced in June. As Business Insider explained it, some of the highlights of the AHCA included:

  • Doing away with Obamacare’s individual mandate that compels all American to buy insurance or face a fine.
  • Featured penalties such as increased premiums for failing to maintain continuous coverage.
  • Allowed people with preexisting conditions to access coverage but penalizing lapses in coverage
  • Introduced block tax credits for individuals to access health insurance

Two versions of the BCRA failed, one in June and one in July. The first version of the BCRA “repealed and replaced Obamacare, but kept many of its regulations and structure, but with large Medicaid cuts.” The second version “kept Obamacare’s taxes to add more sweeteners” but “loosened regulations from Obamacare.”

After the BCRA, smaller versions of the repeal efforts were introduced and defeated. The “partial repeal” and the “skinny repeal” met their demise within a day of each other in July. Most thought that was the end of the efforts, given that John McCain was instrumental in bringing down the “skinny repeal.”

However, in September, one last bill was attempted, the Graham-Cassidy bill. Introduced as the last attempt to pass repeal before the expiration of the budget reconciliation rules, the Graham-Cassidy bill was soundly defeated just thirteen days after it was introduced.

Elation Health will continue to monitor the status of the ACA and any future repeal efforts, in our continuing goal to help independent physicians understand the issues that impact them and their practices.