This week, the Senate and the House are expected to approve an FY 2017 budget resolution instructing congressional committees to write legislation, known as budget reconciliation bills, to rescind many key components of the Affordable Care Act (ACA).  On January 4, 2017, the Senate voted to begin debate on S. Con. Res. 3, the FY 17 budget resolution that begins the repeal process, introduced by Senate Budget Committee Chairman Mike Enzi (R-WY). 

Republicans are using the budget reconciliation process to expedite ACA repeal efforts.  The budget reconciliation process, which is not subject to filibuster in the Senate, consists of two components: (1) approval of the budget resolution by both chambers of Congress, and (2) consideration of reconciliation legislation to carry out instructions contained in the budget resolution.  Senate procedures provide for 50 hours of debate time, equally divided between Republicans and Democrats, on the budget resolution.  After this debate time has expired, senators are allowed to offer amendments to the budget resolution under a marathon voting session known as a “vote-a-rama.”  The House process for considering the legislation will be shorter in duration, with a final vote expected by the end of this week.  The budget resolution does not need to be signed into law by the president; passage of the resolution in each chamber triggers the procedural mechanisms known as reconciliation.

S. Con. Res. 3 directs four committees with jurisdiction over health care policy (House Ways & Means; House Energy & Commerce; Senate Finance; and Senate Health, Education, Labor & Pensions) to submit legislation to the House and Senate Budget Committees by January 27, 2017.  The Budget Committees will then combine the content of these reconciliation bills into a single bill to be considered under expedited procedures and not subject to filibuster in the Senate.  Under the rules of the budget reconciliation process, only certain components of the ACA can be repealed.  It is likely that the reconciliation bills will focus on eliminating the individual mandate penalty, reducing money available for states that opted to expand Medicaid, and repealing subsidies for the purchase of health insurance in the marketplace.

While the timing and content of an ACA replacement is still under debate, on January 4, 2017, Vice President-elect Mike Pence assured House Republicans that President-elect Trump plans to announce executive actions to ensure an “orderly transition for the American people.”  Vice President-elect Pence also promised to work together with Congress on legislation to replace the ACA. 

The budget resolution is available here.