In a 49-to-51 vote taken early Friday morning, the Senate rejected the scaled-down Republican plan to repeal parts of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148). Republican Sen. John McCain of Arizona, along with Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, cast their votes defeating H.R. 1628, the Healthcare Freedom Act of 2017. With a thumbs down gesture, McCain’s cast was the deciding vote.
Although the proposed legislation included much less than what Republicans had planned in its efforts to repeal and replace the ACA, the Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation’s (JCT) prepared estimate of the direct spending and revenue effects of H.R. 1628, the Healthcare Freedom Act of 2017, reported that the bill would have increased the number of people who are uninsured by 15 million next year compared with current law. In addition, premiums for people buying insurance on their own would have increased roughly 20 percent.
CBO’s estimate included the impact of the following provisions of the Healthcare Freedom Act of 2017, known as "skinny" repeal of the ACA:
- Eliminate penalties associated the individual mandate and employer mandate, while keeping those requirements in place. The penalties for large employers would be eliminated only through 2024.
- Eliminate the Prevention and Public Health Fund, beginning in 2019.
- Extend the moratorium on the excise tax on manufacturers and importers of certain medical devices through 2020.
- Increase the maximum contribution limit to Health Savings Accounts for 2018-2020.
- Provide funding for grants to states for applying for or implementing waivers allowed under section 1332 of the Affordable Care Act.
- Increase the amount of funding authorized for and appropriated to the Community Health Center Fund, which provides grant funds to health centers that offer primary and preventive care to patients regardless of their ability to pay.
- Prohibit federal funds from being made available, for one year, to certain entities that provide abortions.
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