Repeal and Replace

On Tuesday, the House voted for the fourth time to repeal the Patient Protection and Affordable Care Act (PPACA). This was the first time during this congressional session and the 56th overall repeal of all or part of the law. The vote for H.R. 596 was 239-186 and included three Republican 'no' votes from Bob Dold (R-IL-10), John Katko (R-NY-24) and Bruce Poliquin (R-ME-2); all of whom represent districts previously represented by Democrats. There were no Democrats who crossed-over to vote yes, with many of those Democrats who supported repeal no longer in Congress. Speaker Boehner contended that this vote allowed the 47 new House Republican members to have a chance to vote against the law. The repeal includes a six-month delay before it would take effect to allow Congress enough time to develop a replacement plan.
The repeal now heads to the Senate where Senator Ted Cruz (R-TX) introduced companion legislation to repeal with a six-month delay. This bill is likely to skip the committee process under Rule 14, and instead head straight to the Senate floor. Majority Leader Mitch McConnell has not yet announced a schedule for a floor vote. Crossing the 60-vote threshold in the Senate will be a challenge, as few moderate Democrats remain to join the chamber's 54 Republicans in voting for repeal. However, there could be potential to pass a repeal in the Senate by the budget reconciliation process, which only requires 51 votes, and was the process by which PPACA was ultimately passed in 2010. Yet, even with a passage, President Obama has made it clear that he will veto a full repeal of the law.