ACA Repeal Legislation

Senate Majority Leader Mitch McConnell signaled Tuesday that there will not be another vote on health care reform before Saturday’s deadline for the use of for budget reconciliation.  (Budget reconciliation allows a legislative package to pass with 51 votes in the Senate instead of the Senate’s usual 60 vote requirement.  The Senate can only use these special rules for health care legislation through the end of the fiscal year, September 30.) Senators John McCain (R-AZ), Rand Paul (R-KY), and Susan Collins (R-ME) had announced their opposition to the Graham-Cassidy bill making it impossible for the bill to pass.

On Wednesday, both President Trump and Senator Paul (R-KY) indicated that the White House is preparing to issue an executive order to allow groups of people to buy health insurance across state lines in an effort to increase competition and lower prices.  Under the Employee Retirement Income Security Act (ERISA), corporations are permitted to buy insurance from providers across state lines, so long as their employees reside in multiple states.  Senator Paul, who suggested the idea, believes ERISA could be reinterpreted to allow individuals to do so.  It is unlikely that this executive order would do anything as under the ACA, states already have the ability to enter compacts to allow insurance to be sold across state lines but insurers have been reluctant to participate—in part because creating plans subject to different state regulations can be costly and time-consuming and most consumers have little incentive to buy coverage that includes out-of-state doctors and hospitals.

Budget

House Budget Chairwoman Diane Black (R-TN) has said the House version of the fiscal year 2018 budget resolution will be on the floor next Thursday.  Senate Budget Chairman Mike Enzi (R-WY) is planning to mark-up a Senate budget next week and it is rumored that text of this Senate budget will be released later today.

Republican leaders in both chambers want to adopt a joint budget resolution swiftly to pave the way for consideration of a tax overhaul measure through the reconciliation process, the special rules that allow for a package to pass the Senate with 51 votes.  The House and the Senate would have to agree on one budget resolution to allow for that to occur.