Affordable Care Act (ACA) Repeal and Replace Defeated

Lauren Pollow and Stephen B. Hanse in Legislative

The scaled-down GOP plan to repeal sections of the ACA has been rejected, with Senator John McCain casting the deciding vote (49-to-51). While the “skinny repeal” was a scaled-down version of the original bill, the impact to health care in terms of affordability and access would have been sweeping. In addition to a repeal and replace, Senate leadership attempted to fundamentally overhaul Medicaid with spending cuts totaling $772 billion over 10 years, covering an estimated 15 million less individuals.

AHCA issued the following statement on the final vote: 


If you were up late last night watching the Senate, you witnessed one of the most dramatic few hours in Senate history. Three Republicans - Lisa Murkowski (AK), Susan Collins (ME), and John McCain (AZ) - voted against the "skinny repeal," joining with all 48 Democrats to defeat the legislation.

There were 51 "no" votes, but all the drama centered on one person - Senator McCain. Less than two weeks out from brain surgery, he not only made the long trek from Arizona, but he also worked through the 16 hours of Senate action on Thursday and early Friday morning leading up to the final vote. He had made noise about possibly voting against skinny repeal all day, but most seasoned watchers believed he would eventually come around. Those that stayed up witnessed Vice President Mike Pence on the floor of the Senate urging him on. But it was to no avail. In one of the most dramatic moments in Senate history, McCain voted no and cemented his legacy as the maverick senator from Arizona. 

It is too early to know what this means for repeal and replace in the long run. In the short term, this debate is over. The House of Representatives leaves today for the August recess. The Senate stays for two weeks to work on other matters. It is very unlikely that there will be much - if any - action on health care for the next few weeks.

What happens in the intermediate and long term will depend on the public. Many Republicans believe and hope that voters will express their anger in the August recess and force action in the fall. Many Democrats believe the opposite will occur. They believe the public will reward those that kept repeal from happening and will be happy that this is over. What happens in town halls across the country in August will matter.

AHCA will closely monitor all developments. We need to thank those that helped us in the Medicaid fight. It is also important to reflect on our interactions with those that did not. Nothing needs to happen today or over the next few days. Everyone involved in the process needs to take a deep breath and absorb all that has happened over the last few months.

But what I want to do with no hesitation, right now, is thank you. Our members from every corner of the country have stepped up to defend our sector and, more important, to defend our residents. There was no need for Medicaid reform to be a part of this, and if it hadn't been, I think we would have stood down on this issue. But policymakers decided that we were not only going to be a pay-for when Congress enacted the Affordable Care Act (ACA), but we were also going to be a pay for when Congress repealed it - and you refused to accept that. Collectively, we had hundreds of meetings, thousands of phone calls, and over 100,000 emails defending our residents. In the end, our long term personal relationships are what mattered the most.

It's been a roller coaster ride, and although it feels like it is over this morning, it's not. Our battle never ends. But our persistence will never end either. They throw everything they have at us, and we just keep going and going. Thanks so much for the honor to work for you, and more important, the honor to work for all of your residents. I know it is incredibly tough right now, but we are going to make it through these challenging times.


Mark Parkinson
President and CEO


Lauren Pollow
Director, Government Affairs
518-462-4800 x25

Stephen B. Hanse, Esq.
President & CEO
518-462-4800 x11