Categorized | Opinion, Viewpoint

Clean repeal, skinny repeal. It all came to nothing

By Al Norman

How often do we get to see elected officials voting on Nothing?

That’s what it came to in Congress the other day. The U.S. Senate could not muster the votes to even discuss “repealing and replacing” the Affordable Care Act. But they exerted more pressure on their members, and finally managed to vote 51-50 to begin to debate some version of repealing the Affordable Care Act. They came up with a replacement bill that would have allowed insurance companies to offer cheap, “stripped down” policies that did not meet federal standards. But that bill lost by a vote of 43 to 57. With conservatives and moderates balking at the “replacement” bill, the leadership turned to a new option: repeal Obamacare. No replacement, just what they called a “clean repeal.”

On July 19, the Congressional Budget Office issued a 19-page “score” of H.R. 1628, the Obamacare Repeal Reconciliation Act of 2017, which would repeal the Affordable Care Act, known as “Obamacare,” and replace it – with Nothing.

According to the Congressional Budget Office, if the Clean Repeal bill passed:

  • the number of people who would have no health insurance would increase by 17 million in 2018, rising to 27 million by 2020, and 32 million by 2036;
  • the average premium for an individual health care plan in the non-group market would rise by 25 percent in 2018, increasing to 50 percent in 2020, and doubling by 2026;
  • half of the nation’s population would live in areas having no insurance companies participating in the non-group insurance market by 2020, rising to 75 percent of the nation’s population by 2026; and
  • repeal of the Medicaid-expanded eligibility under the Affordable Care Act would cut Medicaid spending by $842 million between 2017 and 2026.

On July 26, the Senate tried to pass a Repeal and Replace bill, which failed. Then they filed the Clean Repeal bill – but it failed on a 45 to 55 vote. Just a handful of senators stood in the way of 32,000,000 Americans losing their health care. According to polling, the Repeal Obamacare bill had a favorability rating somewhere around 15 percent.

Lawmakers then pivoted from “Clean Repeal” to “Skinny Repeal,” which would take away the Affordable Care Act mandate that everyone purchase health insurance, but would keep the mandate that all employers offer insurance to their workers. Republican leaders apparently concluded that the only bill which could pass the Senate was this “Skinny Repeal.”

All this political maneuvering demonstrates one thing: the Majority Party in Congress cannot agree on one healthcare bill. They may have control over the House, the Senate and the White House – but they do not have enough control to unify. So divided they fall.

During Senate debate, Minority Leader Chuck Shumer (D-NY) urged his colleagues not to destroy the Affordable Care Act: “We can work together to improve health care in this country. Turn back now before it’s too late and millions and millions and millions of Americans are hurt so badly in ways from which they will never, ever recover.”

The debate will continue, but after months of debate, the American public got just what Congress passed: Nothing.

    Al Norman is the executive director of Mass Home Care. He can be reached at 978-502-3794, or at

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