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On the Hill: Senate Sets the Stage for ACA Repeal Vote

This week, Senate Republicans leaders are hoping to vote on the Better Care Reconciliation Act of 2017 (BCRA) — legislation debuted last week to repeal and replace the Affordable Care Act.

Senate Republican leadership has been working to win over still-uncommitted Republican senators by attempting to balance the policy demands from both Republican moderates and conservatives. After a draft version of the BCRA was released last week, several Senate Republicans either publicly opposed the current version of the legislation or have not officially commented on their position on the bill.

A revised draft of the bill was released on Monday, June 26, to address some Republicans’ concerns, but it made no meaningful changes to the bill’s Medicaid provisions. With Senate Republicans holding a 52-seat majority, they can only afford to lose two votes and still be able to pass the bill.

Next Steps for ACA Repeal Efforts

Under budget reconciliation rules, there are several key steps to passing the bill.

First, Senate Majority Leader Mitch McConnell (R-KY) would call for a motion to proceed to a vote on the House-passed American Health Care Act (AHCA) bill, allowing debate to begin. If there are enough votes to pass this crucial first motion, there would be 20 hours of debate, equally divided between both parties.

After debate, the Senate would proceed to sequential votes on amendments, known as a “vote-a-rama.” Next, there likely would be a vote on a final substitute amendment, which would replace the AHCA with the Senate’s BCRA. Once the amendment has been substituted, the senate would vote on final passage of the BCRA.

CBO Score Expected

The Congressional Budget Office (CBO) is expected to release its score of the BCRA early this week. Outside experts project the bill would reduce health insurance coverage by between 15 million and 22 million people, stemming largely come from the bill’s Medicaid cuts.

America’s Essential Hospitals released a statement last week opposing the BCRA and urged its members to contact their Senate delegations to oppose the bill. The association will continue to provide regular updates to members as the process unfolds this week.

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About the Author

Erin Delaney is the legislative affairs associate at America's Essential Hospitals.

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