When the midterm elections swept Republicans to complete control of Congress starting in January, incoming Senate Majority Leader Mitch McConnell and Speaker of the House John Boehner immediately vowed to repeal the Affordable Care Act. That’s unlikely to happen.
Repeal legislation will probably fail because Republicans will still hold no more than 54 Senate seats—too few to clear two high hurdles: a 60-vote threshold to compel a Senate floor vote, and 67 votes to overturn a veto.
“On health care, there are certainly some lines I’m going to draw,” said President Obama at a post-election press conference. “Repeal of the law I won’t sign.”
McConnell acknowledged the long odds facing repeal: “The veto pen is a pretty powerful tool,” he said.
More likely: “legislative efforts to chip away at the ACA,” said Drew Altman, CEO of the Kaiser Family Foundation. Among measures that might pass and Obama might sign: Redefinition of the employer mandate. Effect: Fewer employers would be required to offer health benefits.
Under the ACA, employers with 50 or more full-time employees must eventually offer health benefits or else pay a penalty. It defines full-time work as 30 or more hours per week. This spring, the House passed a bill that, for ACA purposes, defined a full-time job as 40 hours per week. (The Senate never considered it.) If such a bill passed in 2015, Obama might sign it.
New “copper-level” insurance. Effect: Consumers would have access to cheaper health insurance.
The ACA currently offers platinum-, gold-, silver- and bronze-rated plans, with premiums and coverage declining and out-of-pocket costs rising with each step down the scale.
Copper plans would offer bare-bones, catastrophic coverage with super-low premiums—and very high out-of-pocket costs.
Copper-level plans have champions among both congressional Republicans and Democrats, and the president has not indicated that he opposes the concept.
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