On Friday, January 13, Congress successfully passed a budget resolution with a vote of 51 to 48. This was the first step in the repeal of the Affordable Care Act (a primary goal of the Republican party since Obamacare became law back in 2010). But how does this budget resolution effect the ACA, and how does it affect you?
The Budget Resolution: How does it work?
The budget resolution is not a landmark piece of legislation; rather, it is an annual statement of what the federal government expects to spend during that year. This year, however, had a certain section of the resolution is causing an uproar among adamant Obamacare supporters. This section, “reconciliation directive,” asks for the four committees that control spending on federal health care to reduce the impact the ACA has on the federal deficit. AKA, how these four committees (two in the House, two in the Senate) will defund Obamacare.
Ingeniously, this removes much of the chance Democrats would have to filibuster a bill that repeals Obamacare, for a bill of such a sort would take 60 votes to overcome (the Republicans only hold 52 seats). So, to prevent a Democratic filibuster and failure of such a bill, the Republicans are using a budget reconciliation to defund the ACA. A budget reconciliation can be passed with a total of 51 votes, and a budget resolution is the first step in moving towards a budget reconciliation
The budget resolution, passed by both the House and Senate, then gets sent to committees of jurisdiction to draft the repeal bill. This will take quite some time, for debate over what parts of Obamacare to defund will likely be a slow and arduous conversation. But once it has been decided which parts to defund, the plan will be sent to the budget committee. This committee will turn the entirety of all plans proposed into one large proposal (the budget reconciliation), to be voted on again by Congress. A simple majority wins it for the House, and the Senate only requires 51 votes to pass. Once it passes (and it likely will once the reconciliation is proposed), parts of Obamacare will be repealed. The rest of the ACA, though, will have to be deconstructed with bipartisan support
But what does this have to do with me?
Unfortunately, a lot. America already spends the most of its GDP on healthcare out of any developed nation (a fact that has been consistent since before the ACA), a fact that may seem odd when most all other developed nations have some form of socialized healthcare. But this fact is due, in part, to a large amount of persons who are uninsured in this country. If one is uninsured and they go to a hospital to seek treatment, but can't pay, they will still receive treatment regardless. However, their bill still has to be paid and will default onto the American taxpayers. Thus, in order to pay for those who can't afford pricey insurance premiums, taxes will increase.
In order to help alleviate tax increases and decrease the number of uninsured programs, President Obama signed into law the Affordable Care Act. This, alongside its many other facets, served to get 20 million more people insured, thus reducing the amount of medical bills that end up defaulting back onto American tax payers.
Just a few highlights of the ACA that are likely to start being contested soon:
-Protection for those with preexisting conditions, so that insurance companies cannot refuse you or charge you a higher amount
-Expansion of Medicad and CHIP, so that if you fall below 138% of the Federal Poverty Line, you can be covered by said plans.
-Individual Mandate Penalty which must be paid monthly by all those who opt out of having insurance coverage.
-Employer Mandate that requires all employers with 50+ full-time workers must cover their workers (started in 2016).
-Insurance coverage through your parents up until the age of 26. (A landmark in insurance coverage for many young persons who are full-time students)
The first of these that are likely to see an end in the budget reconciliation is the expansion of Medicaid and the individual mandate. So, things will change most immediately for those who are covered by the expansion of Medicaid, or those who pay a monthly penalty. But, for better, or for worse, with a Republican President and Congress, it is likely the US will watch the dismantlement of the ACA in the coming years.