Battle lines drawn as GOP maps first steps to repeal ACA

Republicans are expected to use the budget reconciliation process to defund key parts of the Affordable Care Act.

With congressional Republicans poised to take their first step in a bid to dismantle the Affordable Care Act, leaders both for and against the healthcare reform law are gearing up for a high-stakes battle.

Republicans are expected to use the budget reconciliation process—as they did in a measure Obama vetoed in 2015—to defund key parts of the law. That would include the penalty for remaining uninsured and subsidies that help make insurance premiums affordable, NPR noted.

The House plans to adopt a package of rules today to clear the way for such a measure, then vote on a budget blueprint during the week of Jan. 9 and act on legislation to carry it out the week of Jan. 30, the New York Times reported. The rules would exempt any bill that replaces or reforms the ACA from being challenged on the House floor, a measure that would normally affect a bill if it introduces new spending.

Democrats, though, are not going down without a fight. In a call with reporters Monday, House Democratic leader Nancy Pelosi characterized the GOP’s plan to repeal the law before crafting a replacement as “an act of cowardice,” according to the Associated Press. And President Barack Obama is expected to host a closed-doors meeting Wednesday with both House and Senate Democrats to discuss how to protect the law, the Wall Street Journal reported.

A coalition of groups seeking to fight for the ACA, meanwhile, is focusing some of its lobbying efforts on Republican senators—including Susan Collins of Maine and Lamar Alexander and Bob Corker of Tennessee—who have expressed concerns over the party’s plan to repeal then replace the law, another WSJ article said.

And echoing concerns from other healthcare industry stakeholders, four medical groups recently sent a letter to congressional leaders urging caution with the ACA repeal process, the American Academy of Family Physicians said in an announcement.

But the GOP, too, is planning to hit the ground running. On the same day Obama plans to huddle with Democrats, Vice President-elect Mike Pence will meet with the full House Republican Conference to discuss their ACA repeal strategy, Politico reported.

Looking further down the road, the GOP is hoping to sell its retooled version of healthcare reform to voters—which it framed as “universal access” rather than mandatory, universal coverage—according to another Politico article. The crux of that strategy is to emphasize less generous coverage in order to drive down healthcare costs, and a key part of the plan will be rolling back many of the new requirements for insurance companies included in the ACA.