Bioethics Blogs

Last Days of the ACA

by Craig M. Klugman, Ph.D.

Politicians are notorious for making campaign promises and then not carrying them out. With the beginning of the 115th Congress, the GOP has doubled-down on its promise to repeal the Affordable Care Act (aka “Obamacare”). How that repeal will happen and what will replace it remains unknown. Both Congress and the courts are lining up court cases and rules that will set up their destruction of this law that has extended health care insurance to 20 million people in the U.S. Starting January 1, several new provisions were supposed to go into effect including expanding protected class status to include those who identify as transgender and those who had receive abortions, and permitting states to apply for exemptions to design alternative programs.

Three events in the last week show the direction in which we are heading:

  1. A new rule for the 115th Congress says that the House cannot consider a bill that dramatically increases the cost of government spending over a 10 year period. But that rule contains an exception for the ACA. The Congressional Budget Office suggests that repealing the ACA would increase the federal deficit by $353 billion in the next ten years. Under the new rule, any law that repeals the ACA should not be considered, except for the exception built in to undo that law. If this seems crazy, realized that the day after agreeing to close the independent Congressional ethics office, the GOP reversed stance, based on a tweet from their party
  2. On December 31, 2016, Judge Reed O’Connor of the US District Court for Northern Texas issued a national injunction against the DHHS from enforcing an ACA nondiscrimination rule.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.