Republicans Aim for 'Skinny Repeal' of ACA Amid Failed Proposals

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After a second proposal failed to pass, Senate Republicans are using a "skinny repeal" to buy time for a large-scale replacement plan.

Less than 24 hours after the rejection of the Better Care Reconciliation Act (BCRA) on July 25, the US Senate voted down another Republican-led effort to repeal larger portions of the Affordable Care Act (ACA), informally known as “Obamacare,” 55-45, on Wednesday.

The repeal attempt, known as the Obamacare Repeal Reconciliation Act (ORRA), sought to remove insurance mandates for individuals and employers, as well as the tax penalty for not obtaining medical coverage, as part of a long-standing effort to completely repeal former President Barack Obama’s 2010 health-care plan.

Several more moderate Republicans were fearful of a full repeal’s effect on the estimated 11 million Americans covered by the ACA in 2017, a rift which in part prevented the bill from passing. The fear may be a legitimate one, with the Congressional Budget Office (CBO) estimating that ORRA would leave 17 million uninsured by 2018.

Sen. John Thune (R-SD) stated that despite not having found the “sweet spot” between the party’s opposing sides, they were “edging closer and closer” to getting to the 50 votes required for a skeletal plan to pass.

Senate Majority Whip John Cornyn (R-TX) agreed, stating that if a “skinny repeal” could be passed, it would buy enough time for the CBO to examine two other plans — one proposed by Rob Portman (R-OH) and another by Ted Cruz (R-TX).

The hope among Senate Republicans is that eventually, their members will act on the idea that some progress is better than none when it comes to the peel back of the ACA, one of the chief legislative goals for the party.

“There is no such thing as a ‘skinny’ repeal; it is a ruse to get to full repeal, with all the concomitant cuts to Medicaid and tax breaks," said Senate minority leader Charles Schumer (D-NY), who has been voicing hopes of a bipartisan agreement for health care. Schumer called the ORRA proposition a “Trojan horse.”

President Donald Trump has expressed concern about Republicans failed efforts to repeal the ACA, a promise he made several times during his 2016 campaign for office. He lamented the vote of several Republican Senators on Twitter Wednesday.

“We’ve got to have a more organized process,” Sen. Ron Johnson (R-WI) said, noting that a “skinny repeal” would be a non-committal action and simply delay the process. “We just don’t have the courage and really the intestinal fortitude to suck it up and do this right.”

The process is also negatively affecting health care providers, as Anthem, which covers more than 1 million Americans under Obamacare insurance plans, threatened to shrink its participation in the 2018 market further due to the uncertainty about government-paid subsidies.

Thune stated that at this point, the most important thing the Republican party needed to determine is “what the traffic will bear, in terms of getting 50 of our members to vote for things that will repeal as much of Obamacare as possible.”

The slimmed-down approach will face opposition from Democrats, and Schumer said the party would not offer any amendments until a full-scale proposal was made.

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