The fate of the Affordable Care Act, aka ACA or Obamacare, has been uncertain in 2017. Republicans in Congress have been determined to find a suitable replacement, but it has been a struggle. For months now, Republican legislators have taken turns drafting new bills, both in the House of Representatives and in the Senate. Each new version has faced opposition not only from Democrats, but even within the Republican Party.

While pressure mounts, mainly from the President, to put a bill up for vote, the lack of a consensus in our legislative houses is quite evident. A number of key senators have expressed specific requirements and provisions that must be included in a new healthcare law and have vowed to vote against any bill that fails to include their desired provisions. While the debate in Congress continues, we are providing you with an outline that illustrates the sequence of events that has taken place since early May, leading up to the latest developments. Since this situation is very fluid and the news reports seem to change almost daily, a timeline may help to clarify what the stumbling blocks are and why the healthcare issue presents such difficulties.

  • On May 4, 2017, the U.S. House of Representatives presented their version of a healthcare bill, known as the American Health Care Act (AHCA). While preserving many aspects of Obamacare, the AHCA presented some clear changes to tax incentives, mandates, and certain public health policies. The House-approved bill was sent to the U.S. Senate for a thorough review.
  • The Senate introduced their own rendition of a healthcare bill on June 22, known as the Better Care Reconciliation Act of 2017 (BCRA). The Senate bill immediately lacked enough Republican support to garner the required number of votes.
  • In response, the Senate unveiled a revised version of their BCRA on July 13. With hopes of satisfying concerns from both political parties, this new version included the Cruz Amendment* and additional funding for opioid treatment.
  • By July 18, the BCRA was still failing to attract enough followers for a vote. Senate Majority Leader Mitch McConnell now focused on swaying senators to vote on a bill that would repeal the ACA within two years, allowing Republicans not only time to write a more thorough and considerate healthcare law, but the time to transition the country to a new healthcare system.
  • The President hosted a luncheon on July 19 for GOP senators, urging them to repeal Obamacare, certainly, but preferably to repeal AND replace. He recommended they cancel their August recess and remain in Washington until a reform bill was finalized.
  • On July 20, Republican senators reopened negotiations on their BCRA legislation, resulting in a second revision which removed the Cruz Amendment* and retained some tax measures included in the Affordable Care Act. Still failing to attract the 50 Republican votes needed to bring the BCRA to the floor for debate and a vote, Senator McConnell announced there would be no replacement in the coming days, and the Senate would proceed to vote on repealing the ACA with a two-year delay. This latest piece of proposed legislation became known as the Obamacare Repeal Reconciliation Act, a repeal-only bill.
  • July 25 and 26 saw marathon debating in the Senate over whether to disassemble Obamacare completely, resulting in the Senate’s rejection of a full ACA repeal without replacement. At this point, Senator McConnell needed to round up 50 Republicans that would back a final bill in some shape or another.
  • On July 27, a “skinny repeal” was debated in the Senate. This legislation, also known as the Health Care Freedom Act, would have repealed the individual and employer mandates contained within the ACA, as well as the medical device tax, and cut off funding to Planned Parenthood. With enough support behind the skinny repeal, Senator McConnell would have been able to introduce a repeal and replace bill to a conference committee with the House, where a more comprehensive proposal could then be negotiated with House Republicans.
  • In the early morning hours of July 28, the Health Care Freedom Act failed to acquire the necessary number of votes, with Senator John McCain (R-AZ) being one of its most vocal opponents. McCain is now urging his colleagues to send the bill back to committee, listen to feedback from both sides of the aisle, as well as our nation’s governors, and “produce a bill that finally delivers affordable health care for the American people”.

With the failure of this latest bill, it appears that Obamacare will remain in effect for now.  However, the President is still hopeful that the Affordable Care Act will be repealed and ultimately replaced. Only time will tell what sort of legislation will be crafted by Congress and presented to the President for signature. As your benefits compliance experts, MidAmerica will continue to monitor the status of healthcare reform and ensure you are aware of any effects new legislation could have on your retirement and healthcare benefit plans.

MidAmerica’s focus is on public sector employers and their ability to provide quality benefits solutions to their employees while meeting their own budget objectives. We provide the guidance, tools, and resources that our clients and partners require in order to effectively administer their retirement and health and welfare plans. We are committed to keeping you informed, and we will provide updates on this topic as they become available.


*The Cruz Amendment, spearheaded by Senator Ted Cruz (R-TX), would allow insurance companies to sell plans that do not meet minimum ACA coverage requirements, provided there is at least one plan offered that will meet coverage requirements.

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