Latest ACA Repeal & Replace Defeated

Lauren Pollow in Legislative

On Tuesday afternoon Majority Leader Mitch McConnell announced he will not be bringing the Graham-Cassidy bill to a vote by September 30th, missing the deadline to pass the bill with a simple majority. The latest repeal bill gained steam suddenly this month, but was ultimately unable to be brought to a vote due to the opposition of three Senate Republicans- Rand Paul (KY), John McCain (AZ), and Susan Collins (ME).

While it is likely the effort to repeal and replace will be revived at a later date, Senate Republicans indicated to media outlets there will be no further attempts for the remainder of this year. AHCA/NCAL and NYSHFA/NYSCAL have been following the negotiations closely, please see the following statement from AHCA/NCAL President Mark Parkinson below:

Statement from AHCA/NCAL President Mark Parkinson:

Yesterday afternoon Senator Susan Collins (R-ME) effectively ended the current iteration of the repeal and replace debate by tweeting that she was a firm "no" on the Graham/Cassidy bill. Today, Senate leadership announced they will not vote this week on Graham/Cassidy. Some wanted Leader McConnell to force a vote for this bill, even knowing that the bill would not pass. Leader McConnell refused and this battle is over for now.

While this is not the end of the health care debate, it is a significant victory for many. The Senate can use the reconciliation process only once a year. Reconciliation is the process that allows the Senate to pass legislation with only 51 votes, as opposed to the 60 votes. Senate Republicans used their opportunity for reconciliation this fiscal year on repeal on replace and did not succeed. The clock expires on September 30, at least for this version of the battle.

Already, Senator Lindsey Graham (R-SC) is advocating that the Senate use next year's reconciliation chance on health care. While this is possible, it is not certain that his colleagues will agree. Many Republicans agree that they should use the next reconciliation for tax reform. It is probably the only way they can pass tax reform. While it is procedurally possible to do both tax reform and health care in the same reconciliation bill, it is risky. The last nine months have proven that passing health care reform is very difficult. Putting health care reform in a reconciliation bill with taxes just increases the chance that Republicans could fail on both issues. The next few weeks will be interesting as we see which direction Republicans and their leadership team go.

More Work to Do

At AHCA/NCAL, we were actively working on the rest of our agenda when the Graham/Cassidy bill heated up and the Board directed us to go 24/7 after it. Now, it's time to return to our other priorities.

First, we are continuing to press CMS to delay phase two of the Requirements of Participation. While we continue to make asks of HHS Secretary Price and CMS Administrator Seema Verma, we have also gone to the Hill for help. Senator John Hoeven (R-SD) is circulating a letter, trying to get as many Senators as possible to support the delay. Senator Hoeven's letter is online here. Congressman Jim Renacci (R-OH) is spearheading a similar effort in the House. Rep. Renacci's letter is online here.

Second, we are also pushing our post-acute payment reform plan on the Hill.  CMS is clearly focused on implementing its new payment plan next year. Our plan would pre-empt it and is better for our residents and better for the country. We are pushing it hard.

Third, we remain focused on our assisted living objectives. Events surrounding the hurricanes in Florida and Texas have prompted discussions of additional regulations for both skilled nursing centers and assisted living communities. To the extent those calls for additional regulations might lead to an effort to regulate assisted living at the federal level, we will fight them. In addition, we will continue to defend the ability of assisted living communities to participate in the Medicaid program.

We're Winning Because of You

None of these successes are possible without you. The hundreds of thousands of emails, hundreds of political events, and the scores of personal discussions all matter. The decision of our sector to unite matters. The generous and, at times, over-the-top political contributions matter. The efforts of both assisted living and skilled nursing providers on the Medicaid issue matter. And most important: the quality of care you provide and our ability to show progress matters most.

If we can keep all these efforts up, we will continue to win. Thanks so much for the opportunity to be a part of it.


Lauren Pollow
Director, Government Affairs
518-462-4800 x25