No Rest for the Weary: Repeal Fever is Back in D.C.

By Jill Zorn |

At a time when a majority of Americans at last have a favorable view of the Affordable Care Act (ACA), there are still public officials and conservative operatives doing all they can to destroy it.

In one of the latest efforts, a group of right-wing think tanks have come together to develop The Health Care Choices Proposal, which they expect Congress to take up this year.

Don’t be fooled by the positive-sounding name.  This wolf in sheep’s clothing proposal looks very much like the Graham-Cassidy bill rejected last year by Congress.  If it passes, it will decimate health care coverage for millions of Americans.

It proposes to block-grant Medicaid, or at least the part of Medicaid that expanded coverage under the ACA, and prevent states that haven’t yet expanded Medicaid from doing so.  Federal subsidies that help people afford insurance through the ACA marketplace would also be block-granted.  Over time, states like Connecticut that have worked hard to implement the ACA would lose the federal dollars we rely on to fund it and would be hurt the most.

Other anticipated negative impacts include:

  • Much higher premiums
  • Comprehensive coverage would become unaffordable
  • People with pre-existing conditions could lose coverage


In order for this proposal to move forward, Congress will have to adopt budget reconciliation instructions that would allow an anti-ACA bill to pass the Senate with only 51 votes.  The House, which is working on a 2019 budget that proposes huge cuts to safety net programs, is already considering reconciliation language.

The question is, would a repeal proposal pass during an election year where health care is still a very hot issue?

Here is one assessment of its chances, both this year and next from an article in the LA Times, which underscores the importance of the midterm elections:

The plan….faces long odds on Capitol Hill, where GOP leaders remain wary of reopening the healthcare debate after last year’s failed repeal efforts embarrassed the party and fueled a broad public backlash.

But the new call for a repeal push underscores how committed many Republicans remain to scrapping the 2010 law, often called Obamacare.

And the plan’s recommendations may serve as a guidepost for GOP lawmakers next year, should the party retain control of the House and Senate after this fall’s midterm elections.

Piling on

When it comes to protecting the hard-won gains of the ACA, there is no rest for the weary.  This proposal is only one in a series of ongoing threats to the law, including December’s tax bill which eliminated the individual mandate, an anti-ACA lawsuit, a changing Supreme Court and ongoing Trump administration sabotage.

Before we can move forward with the kind of big changes we need to lock in universal coverage and care for all Americans, we will have to stop the erosion of our current far-from-perfect system.  Even though we would rather be focused on offense, on laying the groundwork for a much better system, we will also have to keep playing defense on health care, as on so many other crucial issues.


To learn more about this latest threat to the ACA, check out what several DC-based organizations have to say:

Center for American Progress

Georgetown University Center for Children and Families

Center on Budget and Policy Priorities

National Health Law Program