Mere days after the announcement of a Senate vote on the Graham-Cassidy Bill, a healthcare bill brought forward by Republican Sens. Lindsey Graham and Bill Cassidy, the vote was canceled following a declaration of opposition from Republican Sen. Susan Collins. Her announcement followed those of Sens. John McCain and Rand Paul, who also voiced their opposition to the bill, although each for their respective reasons. With yet another failed effort to repeal and replace the Affordable Care Act (ACA), the question of what is to come still lingers among the concerns of healthcare providers around the country.
The defeat of the Graham-Cassidy Bill signals the likely end of attempts to repeal and replace the ACA. Out of the 52 Republicans in the Senate, 50 votes are needed to pass this legislation before today’s deadline to make use of special budget reconciliation rules. With the loss of Sens. Collins, McCain and Paul, any chances of passing the bill were immediately doomed. Once the deadline passes, Republicans will need to amass 60 votes in the Senate, a virtual impossibility with complete opposition from Senate Democrats, effectively killing all efforts to repeal and replace the ACA for the foreseeable future.
Healthcare providers were once more relieved upon hearing word of the failure of the Graham-Cassidy Bill, especially as the Congressional Budget Office announced that the bill would have reduced federal spending on Medicaid by $1 trillion over the course of a decade. Had the bill passed, this cut would have exacerbated the already immense underfunding of healthcare and long-term care facilities across the nation, forcing many to cease operation as Medicaid reimbursements are reduced even further. This reduction would put the security of nursing home and long-term care residents, of which approximately two-thirds are covered by Medicaid, at risk.
Meanwhile, the desire to resume bipartisan efforts to stabilize the health insurance markets, a process interrupted by the Graham-Cassidy Bill, has been voiced by both parties and may lead to changes in how health insurers and their policies operate under the ACA.
No matter the changes to come, the most important thing that healthcare providers should keep in mind is that the ACA is still in effect. Any major healthcare legislation is likely to be pushed to the sidelines for months, if not years to come. Of particular interest to long-term care facilities is that PBJ reporting is still mandated under the ACA. In fact, not only is PBJ reporting still required, but the consequences for non-compliance could soon become more serious as CMS makes PBJ data public as of Nov. 1.
Though the battle over healthcare legislation seems to be over, Republicans, including President Trump, are keeping providers on their toes by making it clear that the current reprieve for the ACA will only be temporary.
If the filibuster rule, which puts into place the requirement for 60 votes in the Senate, were to be removed, Republicans may have yet another opportunity to purse the repeal and replacement of the ACA. Another, yet less likely, option would be for the Republicans to pass a new budget resolution and set up a new reconciliation process.
As we wait for the next shift in healthcare legislation, make sure your facility is prepared for what’s already at your doorstep with our ACA compliance solutions.
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