By early afternoon of January 3, 2017 Senate Republican began the process of a repeal of the Affordable Care Act.  Senator Mike Enzi (R-WY) introduced a Senate Budget Resolution (S.Con.Res.3) and debate began with a clock of 50 hours of Senate debate.  The resolution will eventually provide a reconciliation process to fast track the repeal of the ACA.  The House will then agree to the budget resolution.  The Senate is expected to continue their debate and eat up the 50 hours of debate sometime Tuesday.  They are likely to have a day of voting on various amendments and then send it to the House which is expected to finish it perhaps this week.

A budget resolution is necessary to allow for a reconciliation.  The resolution is agreed to by the two houses but not signed by the President. The main purpose of this budget resolution is to create a budget reconciliation bill.   A reconciliation imposes two critical limitation on the Senate: it limits debate to 50 hours and prohibits a filibuster that in turn means a reconciliation bill can repeal the ACA with just 50 votes (plus the Vice President).  Senate Republicans now hold 52 Senate seats.

This budget resolution is very simple in language but dramatic in impact.  It will empower the key committees in the Senate and the House to report legislative language by January 27 to repeal the ACA.  The instruction to the Senate HELP and Finance Committees and the House Ways and Means and Energy and Commerce Committees provides a token directive to find $1 billion in savings.  This is because the reconciliation process was originally designed to reduce deficits by changing revenue (i.e. taxes) or reducing mandatory (i.e. entitlement) spending.

It is almost certain the reconciliation will not immediately replace the current ACA and so it is likely to be a “repeal and delay” bill with Congress given some time to implement a replacement.  It is unclear what that replacement will look like or how long it will take to implement it.  Open discussions have focused on a two-year to three-year timeframe but Senate and House Republicans are still discussing their options behind closed doors.  Last week Vice President-Elect Mike Pence met with Republican members of Congress to strategize. Some Republican senators have expressed concerns about repealing without a replacement but it is not clear they would actually vote to stop a repeal.