On Wednesday, January 19, the House voted to approve a bill that would repeal the Affordable Care Act of 2010 in its entirety. The legislation, H.R. 2, was approved on a 249-185 vote, with all Republicans supporting it and all but three Democrats voting against it. The House vote was largely symbolic, as Senate Majority Leader Harry Reid (D-NV) has said the Senate will block the legislation, and President Obama has stated that he would veto any repeal bill.
House Republicans will now move on to a different strategy to stall the implementation of health reform by pursuing funding cuts and repealing individual provisions of the law. The Republican leadership has not stated which portions of the law it will attempt to repeal first, but potential targets include a new tax reporting requirement for businesses, the Medicaid expansion, and the Prevention and Public Health Fund which is currently supporting grant programs for the co-location of primary care in behavioral health settings. The House will vote today on a resolution to task four committees with crafting a Republican alternative to health reform that meets specified goals such as decreasing the number of uninsured and reforming the medical malpractice system. While it is unclear what will be included in the alternative plan, several of the priorities endorsed by leading Republicans – such as barring pre-existing condition exclusions and allowing young people to stay on their parents’ insurance through age 26 – have already been enacted under the Affordable Care Act.
The Republican leadership has said it also plans to hold a series of hearings and oversight investigations into the cost of the law and its impact on the states. Although the Congressional Budget Office (CBO), the official cost-scoring agency of Congress, has said that repealing the law will add $230 billion to the federal deficit over 10 years, Republicans have dismissed this figure and argued instead that repeal would reduce the deficit by $701 billion. Nonetheless, the new majority has exempted health reform repeal from new House budget rules that require any increase in spending or in the deficit to be offset by spending cuts judged by CBO to have a greater or equal impact.