A budget resolution establishing procedural instructions to set up the repeal of the Affordable Care Act (ACA) was introduced in the U.S. Senate on Tuesday. This move by the Senate’s budget committee chairman on the first day of the new Congress has set into motion the GOP promise to repeal the ACA as its first legislative act. The House is expected to vote on the Senate budget resolution shortly after the Senate vote. However, the repeal process could take months, while developing a replacement plan could take years.

Senate Republicans have agreed to use a budget resolution, allowing them to repeal ACA funding without any Democratic votes. Budget resolutions require a simple majority to pass in the Senate, instead of the 60 votes required to clear procedural hurdles. There are 52 Republicans in the 100-seat chamber.

While the Senate budget resolution is a statement of priorities and lays the groundwork for the repeal of the ACA, it does not have the force of law. To repeal the law, the House Energy & Commerce and Ways & Means committees and the Senate Finance Committee need to meet to develop replacement legislation. The Senate plan introduced Tuesday includes a “repeal and replace” strategy that would require passage of two separate bills.

Looming over the whole process of repealing the ACA are the actions of the health care marketplace. Congressional plans to repeal the ACA without a replacement plan in place could result in more uncertainty in an already fragile marketplace, prompting insurers to leave the individual market and creating chaos for the 20 million Americans insured through the ACA.

In addition to working on a replacement plan, Congress must also act on a handful of health care programs before they expire, including the Children's Health Insurance Program; Prescription Drug User Fee Act; Medical Device User Fee and Modernization Act; and the Veterans' Access, Choice and Accountability Act.

The California Medical Association (CMA) is closely following these issues as they play out in Congress and will be actively engaged in shaping the future of health care reform at the national level. CMA will work to ensure that any resulting legislation will benefit the patients and physicians in California and the nation as a whole. We will also work to keep you up-to-date on any breaking news from the nation’s capital.

Below are the principles that will guide CMA’s advocacy on health care reform.

1. Improve access to physicians
2. Protect state and federal Medicaid funding
3. Ensure Californians do not lose coverage
4. Provide affordable coverage, particularly for low- and moderate-income families
5. Eliminate administrative and regulatory burdens in the Medicaid and Medicare programs
6. Provide a choice of insurers, HSAs and physicians.
7. Maintain reforms on the insurance industry – coverage for pre-existing conditions, 85 percent medical loss ratio and no annual/lifetime limits on benefits
8. Stabilize the individual insurance market
9. Provide access to affordable prescription drugs

Contact: Elizabeth McNeil, (800) 786-4262 or emcneil@cmadocs.org.