White House. HABS Collection, Library of Congress
The election of 2016 saw the GOP obtain control of the presidency and retain control of both chambers of Congress. This created an opportunity for Republicans to “repeal and replace” the Patient Protection and Affordable Care Act (PPACA), better known as Obamacare, passed in 2010. This libguide will track the legislative history of that effort as it happens and contain links to legislative history source documents.
S. Con. Res. 3, which included reconciliation instructions to repeal the ACA, was introduced in the Senate on January 3, 2017 and was passed on January 12, 2017 by a vote of 51 to 48. The House passed S. Con. Res. 3 on January 13, 2017 by a vote of 227 - 198.
Draft legislation began to be introduced in the Senate during January, 2017, including a “compromise” measure—The Patient Freedom Act of 2017, S. 191—and The Obamacare Repeal Act, S. 222, introduced by Sen. Rand Paul (R-KY).
The House Committee on Energy and Commerce introduced four draft bills for consideration by a committee hearing on February 2, 2017. The legislation appeared intended to stabilize insurance markets during the repeal and replace effort. The bills included the Plan Verification and Fairness Act of 2017; State Age Rating Flexibility Act of 2017; Health Coverage State Flexibility Act of 2017; Preexisting Conditions Protection and Continuous Coverage Incentive Act of 2017.
On March 6, 2017, the House Energy and Commerce Committee and Ways and Means Committee introduced committee prints for mark up in the respective committees. The House Energy and Commerce Committee held a mark up session between March 8-9, 2017, passing a committee print in nature of a substitute. The House Ways and Means Committee held a mark up session on March 8, 2017, passing its reconciliation instructions.
The reconciliation instructions were submitted to the House Budget Committee. The House Budget Committee held its mark up on on the reconciliation instructions on March 16, 2017. These were bundled together into the American Health Care Act,H.R. 1628, and reported for review by the full House, with H. Rep. No. 115-52, on March 20, 2017.
The House Rules Committee held hearings on consideration of the bill from May 22-24, 2017. It passed a closed rule committee passed a closed rule for consideration of H.R. 1628 on March 24, 2017. The bill was pulled from floor consideration that same day.
On April 6, 2017, the House Rules Committee held a hearing and passed a new closed rule, H. Res. for consideration of H.R. 1628, with a report, H. Rep. 115-88. No floor action was taken on this resolution.
On May 3, 2017, the House Rules Committee a hearing and passed a new closed rule, H. Res.308 for consideration of H.R. 1628 and H.R. 2192, eliminating "the non-application of certain state waiver provisions to Members of Congress and congressional staff". The House passed H. Res. 308 on May 4, 2017. The House then passed H.R. 2192 that day by a vote of 429-0. The House also passed the American Health Care Act, H.R. 1628, by a vote of 217-213.
On June 22, 2017, a Senate discussion draft amending H.R. 1628, entitled the Better Care Reconciliation Act of 2017, was unveiled and posted on the Senate Budget Committee website. This discussion draft was updated with a few revisions on June 26, 2017. The revised bill was further updated on July 13, 2017. The Senate finally moved to proceed on H.R. 1628 on Tuesday, July 25, 2017 by a vote of 50-50 with Vice President Mike Pence voting in the affirmative. The initial repeal and replace proposal was Senate Amendment 267 to H.R. 1628, the Obamacare Repeal Reconciliation Act of 2017. However, three other proposals were voted down over the remainder of the week. The same day the Senate began debate on the issue, it voted down, by a vote of 47-53, a procedural motion waiving provisions of the Congressional Budget Act for Senate Amendment 270 to Senate Amendment 267 to H.R. 1628. This was “repeal and replace” legislation entitled the Better Care Reconciliation Act, which included an amendment by Senator Ted Cruz (R-TX), allowing for “stripped down” health care plans. On July 26, 2017, the Senate rejected “repeal only” legislation, Senate Amendment 271 to Senate Amendment 267 to H.R. 1628, entitled the Obamacare Repeal Reconciliation Act of 2017, by a vote of 45-55. The Senate took up “skinny” repeal of certain parts of the Affordable Care Act, Senate Amendment 667 to Senate Amendment 267 to H.R. 1628, entitled the Health Care Freedom Act of 2017, on July 27, 2017. This version was defeated early the next morning on July 28, 2017, by a vote of 49-51.
On September 13, 2017, Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV) and Ron Johnson (R-WI) introduced draft legislation as an amendment in the a nature of a substitute to H.R. 1628--the Graham, Cassidy, Heller, Johnson (GCHJ) proposal. An amended proposal was issued on September 24, 2017. The proposal was the subject of a hearing held before the Senate Finance Committee on September 25, 2017.
In the meantime, Senator Lamar Alexander (R-TN), chair of the Senate Committee on Health, Labor and Pensions, and committee ranking member Senator Patty Murray (D-WA), negotiated compromise legislation to fund ACA risk sharing and create waivers for some of the law's requirements. Their legislation, the Bipartisan Health Care Stabilization Act of 2017, was unveiled on October 17, 2017.