Earlier today, President Obama officially vetoed the reconciliation package to repeal major components of the Affordable Care Act (ACA). The bill was passed by the House of Representatives on Wednesday, after originally being passed in the House in October and amended and passed by the Senate in December. This is the first time that a full repeal of the ACA has passed both chambers and reached President Obama, a major objective of the Republican Party after winning control of the Senate in the 2014 midterm elections. Each of the previous attempts that have passed the House stalled in the Senate under the Democratic leadership. The repeal was possible due to the use of the reconciliation process, which only requires a simple majority to pass, instead of the regular order, which requires a 60-vote supermajority. The veto today ends the years-long process of pushing a full repeal of the law during the Obama Administration, as neither chamber has enough support to override the veto (two-thirds of those voting in both chambers—67 in the Senate and 290 in the House). Republican leadership stated this week that they will begin working towards a unified replacement plan to put forward at some point later this year.
The package repeals significant portions of the ACA, including the state-optional Medicaid expansion beginning in 2018, the individual and employer mandates by changing the penalties to $0 as a workaround to budget rules, and the bulk of the law’s 21 tax increases, including the health benefits tax, medical device tax, and prescription drugs tax. It also included language to defund the Prevention and Public Health Fund and repeal the reinsurance provisions. The deal does not repeal the ACA’s risk corridor program. This final vote this week was 240-181, with three Republicans siding with Democrats to oppose the repeal: Representatives Bob Dold (IL-10), Richard Hanna (NY-22) and John Katko (NY-24), joining Senators Susan Collins (ME) and Mark Kirk (IL) who voted against the repeal package last month. The repeal was fully anticipated after the White House released its Statement of Administration Policy last month. Republicans are hopeful that the reconciliation package passing will send a strong statement to voters in the November general election that the law can be fully repealed with a Republican president, assuming that they also retain their majorities in both chambers.