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Five Republican senators seek ACA action delay

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Five Republican senators are pushing for opponents of the Affordable Care Act to replace the law when they repeal it, rather than repealing it and working to replace it later.

Related: Kaiser finds strong opposition to ACA repeal-only strategy

Sen. Bob Corker, R-Tenn., has joined with four colleagues to ask the Senate to put delay provisions, Senate Amendment 22 and 23, in Senate Concurrent Resolution 3.

The provisions would give congressional committees until March 3 to come up with a proposal for repealing, de-funding or changing the ACA. The current version of the resolution would require the committees to complete their work by Jan. 27.

In addition to Corker, the other senators backing the proposed amendment include Rob Portman of Oregon, Susan Collins of Maine, Bill Cassidy of Louisiana and Lisa Murkowski of Alaska.

Corker and three of the other senators said in statements about the amendment that they would like to see the Senate vote to repeal and replace the ACA at the same time.

Murkowski said “repeal and replace need to coincide.”

Collins and Portman did not say that repealing the ACA and replacing it must happen at the same time, but they both said Congress must make sure people can keep their current coverage until they can get coverage under the new system.

A sixth Republican senator, Tom Cotton of Arkansas, said last week on MSNBC’s Meet the Press Daily that Congress must repeal and replace the ACA at the same time.

The Republican senators’ concerns about the “repeal now and replace later” strategy are important because Republicans now hold just 52 seats in the Senate.

Vote counting

Supporters of most types of legislation need at least 60 votes to get it through the Senate.

Supporters of budget resolutions and another type of budget legislation, a budget reconciliation resolution, can get those resolutions through the Senate with just 51 votes.

The Senate rules for handling budget measures are complicated. Republicans are hoping they might be able to repeal the ACA completely simply by telling the congressional committees to come up with health care-related budget cuts.

Other Senate watchers say Republicans may only be able to use a budget measure to maim the ACA, by cutting major ACA tax and spending programs, such as the ACA premium tax credit subsidy program and the ACA cost-sharing reduction subsidy program. Those Republicans say an ACA budget measure may end up leaving major portions of the ACA, such as ACA major medical benefits mandates, intact.

Some Democrats could end up voting to de-fund or repeal the ACA, and some Republicans could end up voting to save it.

If all Democrats vote to defend the ACA, then Republicans need support from Murkowski and Cotton to get even a budget measure through the Senate.

If Republicans want to pass an ACA replacement bill, or they want to change the ACA itself with an ordinary bill, they would need to win the support of at least eight Democrats, and they would have to win over one additional Democratic for every Republican senator who decides to oppose the ACA replacement or ACA change bill. 


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