As Congress (the old one, and the one newly seated this month) has been talking about the threatened/promised repeal of the Affordable Care Act, two main approaches have been under discussion: partial rollbacks and revisions of parts of the ACA that they find objectionable, and “repeal and replace,” wherein they repeal the current ACA as a whole and replace it with something that provides exactly the same services and meets exactly the same needs but doesn’t have the word “Obama” in it.
Last night, under cover of darkness, Senate Republicans came through with a third option: “repeal and go fuck yourself,” wherein they repeal the current ACA and replace with jack shit. At 1:00 this morning, following a charmingly named all-night “Vote-a-Rama,” the Senate voted 51-48 along party lines to pass a budget measure that’s the first step in demolishing the ACA. Soon-to-be (because we’re not kidding ourselves here) attorney general Jefferson Beauregard Sessions even made an appearance, sliding in just long enough to make his vote count.
This is not an out-and-out repeal as it stands. This first vote guts budget support for the ACA, which GOP senators were able to do handily because budget reconciliation measures can’t be filibustered — they only needed a simple majority to win. The House votes on the measure as early as Friday, and assuming it passes and Trump signs (a safe assumption), committees will meet to work on repeal legislation.
To be clear: Provisions like protection for people with pre-existing conditions and 26-year-olds still on their parents’ insurance can’t be reversed by a budget reconciliation, because they aren’t budget items. This vote was just the necessary first step in depriving 30 million people of life-saving healthcare, or, as Senate Budget Chairman Mike Enzi said, “sending in a rescue team.”
Trump has asked for a repeal vote “probably some time next week” and a replacement for the ACA “very quickly or simultaneously, very shortly thereafter,” because he is smart and knows how legislation works. In the meantime, constituents interested in heading the measure off at the pass are welcome to call their Representative (on the phone, if possible, at their district office is generally the most effective method) and tell them that people not dying for an act of political theatre is important to you, and that you will support them if they support the ACA and give them nothing but your opposition and contempt if they vote to tear it apart.
(Be nice to the staffers, though. They’re going just as boned as the rest of us if this goes through.)