ACA Repeal and Replacement: Proposals and Action

February 1, 2017

Yellow road sign reading "Affordable Care Act" with a red x over the words to indicate repealing the ACA..Beginning last month, both U.S. President Donald Trump and the U.S. Congress began taking steps to repeal and replace the Affordable Care Act (ACA). However, a single replacement strategy has not yet emerged.

In a new one-page fact sheet, CHRT summarizes the most developed ACA repeal and replacement proposals offered to date and outlines the tentative replacement process.

You can also review CHRT’s companion piece, Select Affordable Care Act Replacement Plans and Implications, for a detailed table summarizing the key features and implications of the most developed full ACA repeal and replacement plans offered to date.

The face sheet summarizes three full replacements for the ACA: the House Republicans’ “A Better Way” proposal, Rep. Tom Price’s “Empowering Patients First Act”, and the Burr-Hatch-Upton “Patient Choice, Affordability, Responsibility, and Empowerment Act”. It also summarizes one partial replacement, the Cassidy-Collins “Patient Freedom Act”.

The fact sheet also details the process to repeal and replace the ACA. We summarize President Trump’s January 20 Executive Order and the 2017 Congressional Action. On January 3, the Senate Budget Committee created a budget resolution to provide framework for a partial ACA repeal using budget reconciliation. On January 12 the resolution received full Senate approval and on January 13 it received full House approval.

The House and Senate committees intended to have draft actual reconciliation legislation by January 27, but this has been delayed. April 15 is the prescribed deadline under current rules for the House and Senate to adopt annual budget resolutions, but this is generally not enforced. June 15 is the prescribed deadline to enact any reconciliation legislation, but this is also generally not enforced.