September 2017

This week, after three Republican senators announced their opposition, Senate Majority Leader Mitch McConnell (R-KY) announced the Senate would not consider the Graham-Cassidy bill this week. The decision of Senators Rand Paul (R-KY) Susan Collins (R-ME) and John McCain (R-AZ) effectively ends the ability of the Senate to consider health care reform legislation under budget reconciliation rules which expire Sept. 30, 2017. Budget reconciliation rules allow major legislation impacting federal taxation and spending to pass with a simple 51 vote majority and are not subject to filibuster votes that most other legislation must pass.

Immediately after the demise of the Graham-Cassidy bill, there was some discussion that House and Senate Republicans would seek to use the fiscal year 2018 budget reconciliation agreement to address both tax reform and health care reform, however key leaders in the Republican party have clarified that they intend to use the 2018 budget reconciliation agreement to focus solely on taxes.

The decision to halt consideration of the Graham-Cassidy bill and the announcement that Congress will focus on taxes in 2018 means that the legislative efforts to repeal and replace the Affordable Care Act will likely take a one year respite.

Shortly after the decision to halt consideration of the Graham-Cassidy bill, Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) announced progress on bipartisan legislation to stabilize the private insurance market. While the outcome of the bipartisan legislation is far from certain, the Senate appears to be poised to take action to stabilize the private insurance market by ensuring federal payments for premium and copay subsidies while providing states greater flexibility in implementing insurance reforms.

Because of the anticipated increase in the number of uninsured and due to the financial impacts the scheduled Medicaid cuts would have on patients and providers, the ATS actively opposed the Graham-Cassidy bill. The ATS joined a large coalition of physician and health groups in opposing the bill, including the American Medical Association, the American Hospital Association, the American College of Physicians, the American Association of Family Physicians, the American Academy of Pediatrics, among many other health groups.