LibGuides: Legislative History of the "Repeal and Replacement" of Obamacare: Bills

White House. HABS Collection, Library of Congress

115th Congress: Senate

Bipartisan Health Care Stabilization Act of 2017
Compromise bill introduced by Senator Lamar Alexander (R-TN) and Patty Murray (D-WA) on October 17, 2017. The bill would extend risk sharing payments under the ACA for two years and waives from some of the law's requirements.
Amended GCHJ Proposal
Amendments to draft legislation introduced by Senators U.S. Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV) and Ron Johnson (R-WI) on September 24, 2017. This is an amendment in the nature of a substitute to H.R. 1628.
Graham-Cassidy-Heller-Johnson (GCHJ) Proposal
Draft legislation introduced by Senators U.S. Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV) and Ron Johnson (R-WI) on September 13, 2017. This is an amendment in the nature of a substitute to H.R. 1628.
Sen. Amendment 667 to Sen. Amendment 267 to H.R. 1628 (as proposed)
Health Care Freedom Act of 2017, or "skinny repeal" as proposed. 163 Cong. Rec. S4399 - S4400 (July 27, 2017) . Not agreed to, 49-51, on July 28, 2017.
Sen. Amendment 667 to Sen Amend. 267 to H.R. 1628 (as submitted)
Health Care Freedom Act of 2017, or "skinny repeal" as submitted. 163 Cong. Rec. S4579 - S4580 (July 27, 2017) . Not agreed to, 49-51, on July 28, 2017.
Sen. Amendment 271 to Sen. Amendment 267 to H.R. 1628
Obamacare Repeal Reconciliation Act of 2017, originally released on July 19, 2017 with amendments. 163 Cong. Rec. S4218-4222 (July 25, 2017). Defeated 45-55 on July 26, 2017.
Sen. Amendment 270 to Sen. Amendment 267 to H.R. 1628
Better Care Reconciliation Act, including the Cruz Amendment, released July 13, 2017. 163 Cong. Rec. S4200 - S4218 (July 25, 2017) Motion to waive all applicable budgetary discipline with respect to amendment rejected 43-57 on July 25, 2017 and it was ruled out of order.
Sen. Amendment 267 to H.R. 1628
Senate Obamacare Repeal Reconciliation Act of 2017, originally released on July 19, 2017 with amendments. 163 Cong. Rec. S4197-4199 (July 25, 2017).
Obamacare Repeal Reconciliation Act of 2017
Amendment in nature of substitute to H.R. 1628 posted on the Senate Committee on the Budget's website on July 19, 2017
Better Care Reconciliation Act of 2017 Updated Revised Discussion Draft
Updated revised draft. released on July 13, 2017, increasing funding to combat opioid addiction and retaining some ACA taxes. The Cruz Amendment, Title III in brackets, would allow insurers to sell cheaper, reduced coverage plans.
Better Care Reconciliation Act of 2017 Revised Discussion Draft
Revised draft. released on June 26, 2017, including changes for stability funding to CHIP, new section on penalty for breaks in continuous coverage and realignment of section numbers.
Better Care Reconciliation Act of 2017 Discussion Draft
Senate discussion draft for amendment to H.R. 1628, the American Health Care Act. This was "unveiled" on June 22, 2017.

The Obamacare Repeal Act, S. 222 (2017).
Legislation to repeal PPACA introduced by Senator Rand Paul on Jan. 24, 2017, named The Obamacare Repeal Act. Containing similar proposals offered by other GOP plans, a key difference is that it offers a tax credit for money placed in HSAs instead of a tax deduction. A summary can be found here.
Patient Freedom Act of 2017, S. 191 (2017).
Patient Freedom Act of 2017, providing states with option to keep PPACA, Roth HSAs or developing their own plans.

Patient Freedom Act of 2017 Draft
Draft of the Patient Freedom Act, providing states with option to keep PPACA, Roth HSAs or developing their own plans, which would become S. 191. Documents accompanying the draft's introduction can be found here.

The PPACA repeal phase began on January 3, 2017 with the publication of a draft concurrent resolution by the Senate Budget Committee.

S. Con. Res 3 (2017).
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Reconciliation instructions introduced in Senate.

Senate Budge Committee Draft Reconciliation Instructions
This contained reconciliation instructions to the House and Senate committees with jurisdiction over health care "to submit changes in laws to reduce the deficit" by $1,000,000,000 over fiscal years 2017 - 2026. The Senate committees with jurisdiction are Finance and Health, Education, Labor and Pensions. The House committees are Energy and Commerce and Ways and Means.

115th Congress: House

American Health Care Act, H.R. 1628, reported from House Rules Committee (2017).

House Rules Resolution (III) for Eliminating State Waiver Provisions for Members of Congress, H.R. 2192 and American Health Care Act, H.R. 1628, H. Res. 308 (2017)
House Rules Committee Resolution for consideration of the American Health Care Act, passed (235-192) on May 4, 2017.
Eliminating State Waiver Provisions for Members of Congress, H.R. 2192 (2017), introduced.
Amends the Public Health Service Act to eliminate the non-application
of certain State waiver provisions to Members of Congress and congressional
staff.

American Health Care Act, , H.R. 1628 (2017), Upton Amendment
Amendment #34, introduced by Rep. Fred Upton (R-MI), increases the Patient and State Stability Fund by $8 billion from 2018 - 2023 to States with approved community rating waiver, as established by the MacArthur Amendment. Also resolves two minor technical drafting amendments, including the correction of an inaccurate cross-reference and to ensure proper labeling of subsections. Reported in H. Rep. 114-109 (2017), accompanying H. Res. 308 (2017).
H.R. 1628 (2017), H.R. 1628 (2017), American Health Care Act, MacArthur Amendment.
Amendment # 33, offered by Rep. Thomas MacArthur (R-NJ) allowing states to waive essential health benefits, age rating, and community rating. Reported in H. Rep. 115-109, accompanying H. Res. 308 (2017).

House Rules Resolution (II) for American Health Care Act, H. Res. 254
House Rules Committee resolution for consideration of American Health Care Act, amended to include risk sharing program.

American Health Care Act, H.R. 1628 (2017), Palmer and Schweickert Amendment
Amendment #32, creating $15 billion risk sharing program to help states lower premiums for health coverage offered in the individual market. Reported in H. Rep. 115-88, accompanying H. Res. 254, and 115-109, accompanying H. Res. 308.

House Rules Resolution (I) for American Health Care Act, H. Res 228
House Rules Committee Resolution for consideration of the American Health Care Act, passed (230-194) on March 23, 2017.

American Health Care Act, H.R. 1628 (2017), Amendment to Manager's Amendment, Policy Changes
Walden and Brady Amendment (Amendment #31) to Manager's Amendment to American Health Care Act reported to House floor by House Rules Committee. Reported in H. Rep. 115-58, accompanying H. Res. 228 (2017).
American Health Care Act, H.R. 1628 (2017), Amendment to Manager's Amendment, Policy Changes
Walden Amendment (Amendment #25) to Manager's Amendment (Amendment #5) to American Health Care Act reported to House floor by House Rules Committee. Reported in H. Rep. 115-58, accompanying H. Res. 228 (2017).
American Health Care Act, H.R. 1628 (2017), Manager's Amendment, Policy Changes
Substantive amendments (Amendment #5) to bill reported to House floor by House Rules Committee. Reported in H. Rep. 115-58, accompanying H. Res. 228 (2017).
American Health Care Act, H.R. 1628 (2017), Amendment to Manager's Amendment, Technical Changes
Brady and Walden Amendment (Amendment #24) to Manager's Amendment to American Health Care Act (Amendment #4) reported to House floor by House Rules Committee. Reported in H. Rep. 115-58, accompanying H. Res. 228 (2017).
American Health Care Act, H.R. 1628 (2017), Manager's Amendment Technical Changes,
Amendment #4: Technical corrections to bill reported to House floor by House Rules Committee. Reported in H. Rep. 115-58, accompanying H. Res. 228 (2017).

American Health Care Act, H.R. 1628 (2017).
Reconciliation instructions from House Energy and Commerce and Ways and Means Committees passed by House Budget Committee on March 16, 2017.

The House Ways & Means Committee divided its provisions of the American Health Care Act into five separate parts: budget reconciliation legislative recommendations relating to remuneration from certain insurers; repeal of tanning tax; repeal of certain consumer taxes; repeal of net investment income tax; and repeal and replace of health-related tax policy.

House Ways & Means Budget Reconciliation Legislative Recommendations Relating to Remuneration from Certain Insurers
House Ways & Means Committee amendment to provision of the American Health Care Act approved by mark up on March 8, 2019.
House Ways & Means Budget Reconciliation Legislative Recommendations Relating to Repeal of Tanning Tax
House Ways & Means Committee amendment to provision of the American Health Care Act approved by mark up on March 8, 2019.
House Ways & Means Budget Reconciliation Legislative Recommendations Relating to Repeal of Certain Consumer Taxes
House Ways & Means Committee amendment to provision of the American Health Care Act approved by mark up on March 8, 2019.
House Ways & Means Budget Reconciliation Legislative Recommendations Relating to Repeal of Net Investment Income Tax
House Ways & Means Committee amendment to provision of the American Health Care Act approved by mark up on March 8, 2019.
House Ways & Means Budget Reconciliation Legislative Recommendations Relating to Repeal and Replace of Health-Related Tax Policy
House Ways & Means Committee amendment to provision of the American Health Care Act approved by mark up on March 8, 2019.
American Health Care Act, House Energy & Commerce Marked Up Reconciliation Bill
Marked up bill that passed the House Energy & Commerce Committee on March 9, 2017.
American Health Care Act, House Energy & Commerce Reconciliation Bill.
American Health Care Act, House Energy & Commerce Reconciliation Bill
Committee print of budget reconciliation instructions introduced for markup in House Energy and Commerce Committee. This was introduced on March 6, 2017.
American Health Care Act, House Ways & Means Reconciliation Bill.
Committee print of budget reconciliation instructions introduced for markup in House Ways & Means Committee. This was introduced on March 6, 2017.

Requiring Individual Responsibility in Medicaid Act of 2017 (2017).
Bill introduced by Rep. H. Morgan Griffith (R-VA) allowing states to establish work requirements on Medicaid beneficiaries. This bill was incorporated into the manager's policy changes amendment to the American Health Care Act, H.R. 1381 2017).
World's Greatest Healthcare Plan of 2017, H.R. 1275 (2017).
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"Compromise" legislation, introduced by Rep. Pete Sessions (R-TX), that eliminates the PPACA's individual and employer mandates, but keeps exchange system in tact. Individuals can choose to opt out from ACA for tax credits.
Small Business Health Fairness Act of 2017, H.R. 1101 (2017).
Bill allowing small businesses to create their own health insurance plans called Association Health Plans. This was introduced on February 16, 2017.

House Discussion Draft
Draft Republican House discussion draft proposal leaked February, 24 2017.

Obamacare Replacement Act, H.R. 1072
Companion bill to S. 222 (2017), introduced by Rep. Mark Sanford (R-SC) on February 15, 2017. This legislation is supported be members of the House Freedom Caucus.

The House Committee on Energy and Commerce introduced four draft bills for consideration by a committee hearing. The legislation appeared intended to stabilize insurance markets during the repeal and replace effort.

Plan Verification and Fairness Act of 2017, Discussion Draft
Draft bill under consideration by House Committee on Energy and Commerce, requiring Department of Health and Human Services to verify qualifications of enrollees during special enrollment periods.
State Age Rating Flexibility Act of 2017, Discussion Draft
Draft bill under consideration by House Committee on Energy and Commerce increasing ratios capping premiums insurers can charge older enrollees over younger enrollees.
Health Coverage State Flexibility Act of 2017, Discussion Draft
Draft bill under consideration by House Committee on Energy and Commerce, reducing grace period for enrollees to make late payments.
Preexisting Conditions Protection and Continuous Coverage Incentive Act of 2017, Discussion Draft
Draft bill under consideration by House Committee on Energy and Commerce forbidding denial of insurance based on preexisting conditions, under certain circumstances, if PPACA is repealed and replaced with prior law.

H. Res. 48 (2017).
House Rules Committee resolution for consideration of S. Con. Res. 3 (2017). The resolution also provides for consideration of S. 84 (2017) which provides an exemption to the limitation on recent active duty officers serving as Secretary of Defense.

114th Congress: Senate

World's Greatest Healthcare Plan Act of 2016, S. 295 (2016).
Named "The World's Greatest Healthcare Plan Act of 2016", this legislation, introduced by Sen. Bill Cassidy (R-LA), contains elements that would later be included in S. 191 (2017), The Patient Freedom Act of 2017.

114th Congress: House

World's Greatest Healthcare Plan Act of 2016, H.R. 5284 (2016).
"Compromise" legislation, introduced by Rep. Pete Sessions (R-TX), that eliminates the PPACA's individual and employer mandates, but keeps exchange system in tact. Individuals can choose to opt out from ACA for tax credits.
Reconciliation Legislation, H.R. 3762 (2015).
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Reconciliation legislation that repealed elements of the PPACA and is widely regarded as a model for the repeal and replace effort in the 115th Congress. This passed both chambers on January 6, 2016 and was presented to President Obama on January 7, 2016. President Obama vetoed the bill on January 8, 2016. A House attempt to override the veto failed on February 2, 2016.
Empowering Patients First Act, H.R. 2300 (2015).
The Empowering Patients First Act introduced by then Rep. Tom Price (R-GA).

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Legislative History of the "Repeal and Replacement" of Obamacare: Bills

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115th Congress: Senate

115th Congress: House

114th Congress: Senate

114th Congress: House

Lindsay Steussy