The House voted 227 to 198 Friday afternoon to approve a budget bill that sets the stage to dismantle the Affordable Care Act.
The measure passed the Senate by a 51-48 party-line vote the day before. The bill itself doesn't repeal the health care law but puts the process in motion.
WHAT DOES THE BILL DO?
The bill instructs four committees — two in the House and two in the Senate — to each write bills that cut at least $1 billion from the deficit over a decade. Their deadline is Jan. 27. The House and Senate Budget committees would then combine the measures to create an ACA repeal package.
The complex process, known as budget reconciliation, requires only 51 votes to pass the Senate, allowing the GOP to sidestep a filibuster by Democrats.
» The Affordable Care Act in Georgia
Reconciliation can only be used to change laws that cost money or are implemented as taxes. So for instance, Republicans could use it to end funding for Medicaid expansion under the law or do away with the individual mandate that requires every American, if they can afford it, to buy health insurance or pay a penalty.
The process likely would not allow Congress to strip away other parts of the law, such as the requirement that insurers can’t deny people coverage because of a pre-existing condition.
In the end, however, it has the power to gut key parts of the health care law that could then lead to the collapse of its other major elements.
WHAT DOES IT MEAN FOR GEORGIA?
In short, we don’t know yet.
More than 480,000 Georgians have signed up so far for Obamacare coverage for 2017. The Obama administration has promised that 2017 plans will remain valid through the end of the year.
But experts warn that even if Congress takes a “repeal and delay” approach to dismantling the law — with some of the changes not taking effect for years — it could still result in major disruptions to the country’s individual health insurance market and strip millions of Americans of their health coverage.
It also leaves up in the air whether Georgia will expand its Medicaid program to more than half a million uninsured residents. Right now, state lawmakers aren't making any big policy decisions and are instead hoping to influence what happens in Washington.
WHAT COMES NEXT?
Once the four committees have completed their reports, the House and Senate Budget committees will combine them into one or two pieces of legislation to be voted on.
If passed, legislation could hit President-elect Donald Trump’s desk as soon as next month.
The path to repealing the Affordable Care Act, however, is proving to be bumpier than many leaders anticipated.
A growing number of GOP lawmakers have voiced concerns about voting for repeal, even if it is delayed, without a replacement plan ready to go. Some Republican governors in states that expanded Medicaid under the law, including John Kasich of Ohio, have also spoken out against repealing with no replacement.
At this point, Republicans have yet to come to an agreement on a replacement plan, much less when that plan would take effect. Trump also said this week that he will unveil his own proposal once his nominee for the Department of Health and Human Services, U.S. Rep. Tom Price of Georgia, is confirmed.
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