Collins, King at center stage of ACA battle

COLLINS PHOTO COURTESY / MEDILL DC, FLICKR, KING PHOTO COURTESY / U.S. NAVAL WAR COLLEGE, FLICKR U.S. Sens. Susan Collins and Angus King are taking leading roles in the fast-breaking legislative battle over President-elect Donald Trump's call for an immediate repeal of the Affordable Care Act.

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By James McCarthy

With his Jan. 20 inauguration just nine days away, President-elect Donald Trump is pushing for the Republican-led Congress to immediately repeal and replace the Affordable Care Act, which he described as a “catastrophic event” in a telephone interview with the New York Times on Tuesday.

But in an interactive graphic, the Times details why repealing the ACA isn’t quite the slam-dunk that Trump and others might imply. In part, the newspaper reported, it’s because the law’s parts are interdependent, making it difficult to remove some aspects while keeping others, as even some Republican lawmakers have said they would try to do.

The NYT reported that five aspects of the law — namely, provisions on pre-existing conditions, essential health benefits, limits on age rating, allowing young people to stay on parents’ policies until age 26 and the ban on setting rates based on health status — would require 60 votes in the Senate to be repealed. Republicans would have 51 votes.

Two aspects of the law — contraceptive coverage and cost-sharing subsidies — the Times reported could be eliminated by President-elect Trump ordering a regulatory change once he takes office.

Long story short: Republicans have their work cut out in fulfilling one of Trump’s and the party’s top legislative priorities early in the new president’s term.

Repeal or delay?

As some congressional Republicans take steps to “repeal or delay” the Affordable Care Act, the White House reported Tuesday that as for Dec. 24 more than 11.5 million people had signed up for ACA plans on the federal and state insurance exchanges. That’s an increase of 286,000 over the previous year’s enrollment, according to Becker’s Hospital Review.

President Obama challenged GOP leaders to come up with a better plan before cancelling coverage for the Americans who signed up for an ACA plan in 2017.

U.S. Sen. Susan Collins, R-Maine, has joined with four Republican senators in introducing an amendment providing additional time to develop an ACA replacement that would protect Americans from losing health insurance.

“In an ideal situation, we would repeal and replace Obamacare simultaneously, but we need to make sure that we have at least a detailed framework that tells the American people what direction we're headed,” Collins said in a statement. “Repeal and replacement is a complicated task, and my No. 1 concern is that we not create a gap in coverage for individuals who are currently insured and who rely on that coverage. By providing more time to come up with legislative solutions, we have a better opportunity to produce a thoughtful, workable replacement that ensures Americans have access to affordable, diverse insurance plans that meet their needs.”

Collins joined Republican U.S. Sens. Bob Corker of Tennessee, Rob Portman of Ohio, Bill Cassidy of Louisiana and Lisa Murkowski of Alaska in introducing an amendment to extend the deadline for budget reconciliation instructions regarding the ACA from Jan. 27 to March 3. The additional time would allow Congress and the Trump administration to develop what Collins’ office described as a “serious replacement to Obamacare.”

King: 'Preserve' critical components of ACA

U.S. Sen. Angus King, I-Maine, introduced five amendments to Senate legislation that would “preserve critical facets” of the ACA.

King’s amendments would accomplish these goals, according to a statement from his office:

Ensure that access to health insurance cannot be denied or that health insurance prices cannot be raised for those working in higher risk, primarily rural sectors such as public safety, forestry, farming and fishing in Maine
Ensure that health insurance will still cover mental health and substance abuse disorders so that those struggling with opioid addiction are able to afford the treatment services they need
Extend a program that seeks to improve child and maternal health in areas, often low-income, with elevated levels of poor childhood health
Ensure the continued support for fall prevention services and programs for older Americans, which can help prevent debilitating injuries and significant medical costs
Support the National Health Service Corps programs that dispatch new medical providers to serve rural areas.

“The Affordable Care Act is not a perfect law, but it corrects some of the most glaring defects in the private insurance system and it provides an opportunity to millions of Americans – including tens of thousands in Maine – to escape the day-to-day shadow of a health care disaster. It would be a mistake of catastrophic measure to go back on that and put people’s lives at risk,” King said in a written statement. “I will continue to fight for the health and well being of rural Mainers and stand in the way of any attempt by anyone in Congress to take health insurance away from them or anyone in my state.”

King’s office said the Senate is expected to vote on a series of amendments to the budget resolution today. If Sen. King’s amendments are voted on, and adopted, they would in effect prevent the repeal or contraction of the programs and services detailed in the amendment.