Resources on the Evolving Health Care Debate

With the Better Care Reconciliation Act (BCRA) losing support in the Senate on Monday evening, Senate Majority Leader Mitch McConnell (R-KY) announced votes to consider the House-passed health bill and an amendment resembling the vetoed 2016 reconciliation bill, which would have partially repealed the Affordable Care Act (ACA or "Obamacare"). The 2016 bill would have repealed the ACA's taxes immediately, repealed its spending on Medicaid and exchange subsidies after two years, and retained its insurance regulations.

Below is some of our previous work informing the health care debate around full repeal and "repeal and delay."

When the "repeal and replace" discussion began at the beginning of the year, we wrote six principles that policymakers need to follow to responsibly repeal and replace the ACA without adding to the debt or reversing the progress on its cost-control measures. We also released a chartbook to illustrate what "repeal and replace" would mean.

We estimated that the 2016 reconciliation bill – the basis for the current "repeal and delay" discussion – would likely save $550 billion over the 2018-2027 budget window (or $750 billion including economic effects).

If policymakers choose to "repeal and delay," we've made the case that they should continue the offsets (the taxes and other savings) for as long as the coverage provisions are continued. Having both parts of repeal take effect at the same time would ensure that repeal-and-delay doesn't add to short-term deficits, and it would discourage Congress from further delaying repeal of the coverage provisions without offsets.

Additionally, we compared how the number of uninsured individuals would change under each repeal scenario – including under the House-passed American Health Care Act (AHCA) and the BCRA – according to the Congressional Budget Office's estimates. "Repeal and delay" would increase the number of uninsured in 2026 by 32 million, more than either the AHCA, BCRA, or full repeal of the ACA.

In January, we wrote about how much fully repealing the ACA would cost, including getting rid of all of the insurance regulations and Medicare cuts. Full ACA repeal would cost $350 billion over the next decade using conventional scoring or $150 billion when considering the economic effects of repeal. However, it wouldn't be possible to fully repeal the ACA in budget reconciliation. You can read more about how reconciliation affects the health care debate here.

As the health care debate evolves, we will continue providing resources to help inform the debate.


Note: This blog originally said that the repeal and delay bill would save $550 billion over the 2017-2026 budget window. The actual window is 2018-2027.