Health Care Reform Comparison: The Long Road to Nowhere - ACA Repeal Effort Over?

After seven years of strong rhetoric, court challenges, attempts to repeal, and threats to stop making cost-sharing
reduction payments called for by the law, the Affordable Care Act (ACA) continues to be the law of the land.

Senate Majority Leader Mitch McConnell (R-Ky.) unsuccessfully tried to garner enough support for the Better
Care Reconciliation Act. That repeal-and-replace effort collapsed after three weeks of work. Attempts to break
the logjam in the Senate culminated in an early-morning vote on July 28 that failed 49-51 to pass the “skinny”
bill, the most modest ACA repeal bill put forth by the Senate Republican leadership. That bill – called the
Health Care Freedom Act – would have

  • repealed the requirement that individuals purchase health care coverage or pay a penalty
  • eliminated the requirement that employers with at least 50 full-time employees provide health care
    coverage to their employees;
  • delayed the medical device tax; and
  • increased the contribution limit for health savings account

Previously, on May 4, the House passed the American Health Care Act (AHCA; H.R. 1628), a much more
ambitious effort to repeal ACA. In addition to repealing the individual and employer mandates, AHCA
would repeal the ACA taxes on high earners, including the net investment income tax, as well as the taxes
on medical device and prescription drug manufacturers and would delay the tax on high-cost health plans
provided by employers. AHCA includes an advanceable, refundable, age- and income-based tax credit for
premiums paid by low-income earners.

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