In an early morning Friday July 28th vote, the Senate Republican leadership’s so-called “skinny” Affordable Care Act (ACA) repeal bill failed to gather the 50 votes required for passage. Senators Susan Collins (R-ME), Lisa Murkowski (R-AK) and John McCain (R-AZ) sided with Democrats in a 49-51 roll call vote.

Released a few hours before the vote, the 8-page bill would have repealed the ACA’s individual mandate, suspended the employer mandate for 8 years, repealed an ACA tax on medical devices, increased contribution limits for Health Savings Accounts (HSAs) for 3 years, expanded the ability of states to apply for waivers of some ACA rules, increased funding for community health centers, and blocked funding for certain health providers who offered abortion services. The Congressional Budget Office estimated that provisions in the bill would have resulted in 16 million fewer persons being uninsured in years 2018-2026 and a 20 percent increase in insurance premiums each year over that same timeframe.

A path forward on health care reform now remains unclear. Following the vote, Senate Majority Leader Mitch McConnell (R-KY) announced that the Senate will return on Monday to consider other business. Minority Leader Chuck Schumer (D-NY) reiterated Democrats willingness to work to address shortcomings of the ACA through the Senate’s regular bill process.  NAR will continue to follow developments with an eye to those provisions that impact the self-employed and small businesses.

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