Straight repeal of ACA back on the table after BCRA fails: 5 things to know

Two more Republican senators defected from the revised Better Care Reconciliation Act Monday evening, effectively sinking the ACA repeal and replacement bill, according to The New York Times.

Here are five things to know about the bill's collapse.

1. The two defectors were Republican Sens. Mike Lee of Utah and Jerry Moran of Kansas. Both are Tea Party senators who opposed the ACA, so their defections came as a surprise, according to Bloomberg. Mr. Moran said in a statement he opposed the BCRA because it "fails to repeal the ACA or address healthcare's rising costs." He added, "We should not put our stamp of approval on a bad policy." Mr. Lee did not support the bill because it did not repeal all of the ACA's taxes or lower premiums enough for the middle class, according to a statement.

2. Without the support of Mr. Lee and Mr. Moran, the bill is dead. Senate Republicans needed at least 50 votes to pass the bill via reconciliation. They hold 52 seats, but two Republicans already announced their opposition: Sens. Susan Collins of Maine and Rand Paul of Kentucky. "Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful," Senate Majority Leader Mitch McConnell, R-Ky., said in a statement

3. Mr. McConnell now wants to return to the full ACA repeal strategy. To do this, the Senate would take up the House bill, the American Health Care Act, and tack on an amendment to repeal the 2010 healthcare law, according to Mr. McConnell's statement. This would repeal the ACA after a two-year delay to allow for Congress to facilitate a transition and a potential replacement. A bill similar to this was passed in 2015, but was repealed by former President Barack Obama.

4. Despite support in 2015, the straight repeal strategy will be tough to pass now. The New York Times report said this strategy "has almost no chance to pass," because it will destabilize insurance markets too much. An analysis from the Congressional Budget Office published in January found 32 million more people would be uninsured by 2026 under the 2015 repeal bill. This would set back insurance rates more than the BCRA or the AHCA, which were estimated to increase the number of uninsured by 22 million and 23 million by 2026, respectively.

5. President Donald Trump is pushing Congress toward the full repeal. He tweeted Monday night, "Republicans should just REPEAL failing Obamacare now & work on a new healthcare plan that will start from a clean slate. Dems will join in!"


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