After Supreme Court Decision, Congress Weighs Options on Affordable Care Act
June 29, 2015 09:04 AM
As previously reported, the Supreme Court on June 26 ruled that individuals who purchase health insurance through a federal exchange are eligible to continue receiving subsidies under the Affordable Care Act.
Prior to the ruling, Republicans in Congress had debated how to respond in the event that the Court struck down the subsidies, with some preparing legislation to provide temporary relief to currently insured individuals while repealing the employer and individual mandates. Following the ruling, Republican lawmakers are necessarily adjusting their approach. Most have conceded the reality that the law is here to stay for the foreseeable future, at least until 2017 when President Obama will leave office.
Val J. Halamandaris, President of the National Association for Home Care & Hospice (NAHC), said on Thursday that the ruling “essentially amounts to a ceasefire in the repeal effort.” In a video released today, Halamandaris further explained that the law is unlikely to be repealed and that instead we should come together to improve it.
Despite the fact that any effort to repeal the ACA is virtually guaranteed to fail due to President Obama’s veto authority, some Republicans are intent to keep up the symbolic fight. One option is to use the so-called budget reconciliation process, which only requires a simple majority rather than 60 votes in the Senate, to pass language repealing or significantly changing the law. Another option is to use Congress’s authority over spending legislation to cut off funding for the bill’s implementation. As of this week, both the House and Senate have advanced funding measures out of Committee that would do just that.
Still the fact remains that, even if Congress were to succeed in passing such a measure, President Obama holds veto authority which he would almost surely use.
Others in Congress have argued for a more practical, goal-oriented approach to change specific aspects of the law where bipartisan agreement might be possible.
“At the end of the day, there is not going to be any complete repeal of the law until there is a new administration,” said Congressman Robert Aderholt (R-AL) according to POLITICO. “But we can’t sit back as a party who stood against it, and pretend that it is what it is and we aren’t going to do anything.”
Even President Obama on Thursday indicated his willingness to consider improvements. “I can work with Republicans and Democrats to move forward,” Obama said in a statement following the ruling. “Let’s join together.”
Given the fact that the health care law is here to stay through at least 2016, NAHC is urging Congress to consider specific measures to improve the law with a particular focus on long-term care and improving chronic care management.
NAHC recommends that Congress change the employer mandate in order to soften the blow it will have against small employers. Following are NAHC’s recommended changes to the employer mandate: 1) exempt home care providers from the mandate; 2) amend the definition of full-time to 40 hours per week; 3) provide subsidies to home care agencies to cover the increased costs of providing insurance to all employees; 4) provide tax credits to home care clients to cover the increased cost of care triggered by the employer mandate; 5) help states provide low-wage home care workers with health insurance through Medicaid.