Congress Lays Groundwork to Dismantle the Affordable Care Act

This week, Congressional Republicans introduced a budget resolution laying the groundwork for repeal of the Affordable Care Act (ACA)—with no replacement in sight. This process uses a set of rules called “reconciliation.” Through budget reconciliation, the majority party in Congress can advance policies through a simple majority vote. But only provisions that are budget related are permitted to be included.

The reconciliation process begins when Congress introduces and agrees to a budget resolution. A resolution is not a law and does not go to the President for a signature. It is simply an agreement between the Congressional houses that they will take future action. The resolution usually includes directives that instruct Congress on how it will act. But in many cases—and in the case of the resolution introduced this week—the instructions are simply that specific Congressional committees will write legislation. In this case, the committees are expected to work up a plan to repeal the ACA without a meaningful replacement.

The rush to repeal and delay the ACA poses significant risks for American families. Estimates show 30 million people could lose health insurance if the ACA is undone without a suitable replacement. Further, such a repeal could cut taxes for the wealthy while piling more costs on lower income people and puts consumer protections, such as requirements for pre-existing condition coverage and limitations on premiums, at risk. It also may increase political pressure to find cash through harmful cuts to Medicare and Medicaid.

While the budget resolution introduced this week does not dismantle the ACA, it’s the first step in a perilous process to repeal health care reform and may also undermine other vital programs, like Medicare and Medicaid.