Congress and the Affordable Care Act

Members Opposed to the Health Reform Law Have Pledged to Repeal It, Replace It, or Block Its Implementation.

In addition to pursuing full repeal of the Affordable Care Act (ACA), congressional Republicans are seeking to block various sections of the law or cut off funding for key provisions. In February, House Republicans approved nine amendments that would block health reform funding as part of a spending bill for the remainder of fiscal 2011.

While these measures face opposition in the Democrat-controlled Senate and the White House, there are a number of avenues that may be pursued to prevent all or parts of the ACA from going into effect, including:

  • Repealing and replacing, which would replace the ACA with alternate health reform;
  • Repealing specific provisions, such as the individual mandate, the prohibition on states to reduce Medicaid eligibility and the employer mandate;
  • Blocking regulations;
  • Holding hearings to rally support for alternate reforms; and
  • Defunding implementation of the ACA.

The uncertainty about how the 2011 budget process will play out brings greater uncertainty about health reform legislation. However 2011 unfolds, they note that many of the same fights are likely to play out again in 2012—both in the federal budget that will be devised for fiscal 2013, and in the general elections that will take place in November 2012.

This Health Policy Brief analyzes avenues that may be pursued to prevent all or parts of the ACA from going into effect, and was published online on February 25, 2011 in Health Affairs.