On Thursday, May 16, 2013, the House will consider H.R. 45, a bill to repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010, under a rule. H.R. 45 was introduced by Representative Michelle Bachmann (R-MN) on January 3, 2013 and has 106 cosponsors.
H.R. 45 repeals the Patient Protection and Affordable Care Act in its entirety. In addition, H.R. 45 repeals title I and subtitle B of title II (health care-related provisions) of the Health Care and Education Reconciliation Act of 2010 (the health care-related provisions). H.R. 45 restores the provisions of law in place prior to enactment of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.
On March 23, 2010, the Democratic House and Senate passed, and the President signed into law, the Patient Protection and Affordable Care Act. The legislation passed by a vote of 219-212 (see Roll Call #165). Later on March 25, 2010, the Democratic House and Senate passed, and the President signed into law, H.R. 4872, the Health Care and Education Reconciliation Act of 2010, which passed by a vote of 220-207 (see Roll Call #194). Among other things, the law requires that most individuals obtain health insurance or pay a penalty tax; requires employers with 50 or more full time employees to provide approved health care coverage or pay a penalty tax; establishes insurance exchanges through which individuals and families will receive taxpayer-funded premium subsidies; expands Medicaid; cuts Medicare by $716 billion; imposes 21 additional taxes on health insurance plans, medical devices, businesses, families, and individuals at a cost of $1.1 trillion. CBO’s February 2013 coverage estimate puts the total cost of coverage at $1.88 trillion up significantly from its initial 2010 estimate of $940 billion.
Since the beginning of the 112th Congress, the House has voted 36 times to repeal, defund, or dismantle in full or in part PPACA. This includes two full repeal votes on January 19, 2011 and July 11, 2012, both of which passed by votes of 245-189 (see Roll Call #14) and 244-185 (see Roll Call #460), respectively. The House voted to repeal PPACA on three additional occasions in the FY 2012, 2013 and 2014 Budget Resolutions. As a result of these efforts, 7 different bills have been enacted that directly repeal or rescind funding from at least 8 different provisions of PPACA.
As the October 1, 2013 enrollment date and the January 1, 2014 implementation date approach, the evidence that PPACA will have significant consequences on patients, our nation’s healthcare system, taxpayers, job holders, job creators, individuals, families, and the economy continues to grow. This week, three House Committees together released a compilation of their respective oversight activities highlighting the impact that the law is already having. Among the many implications, the Committees highlighted the 190 million hours per year that American families will be forced to spend complying with PPACA’s requirements; the likelihood that seven million people will lose their employer based insurance; the increase in health insurance premiums by as much as 400 percent for individuals and 100 percent for the small group market; the $716 billion cuts to Medicare; the $628 billion expansion of Medicaid to mostly childless adults, the 159 new government boards, including IPAB, and the 800,000 job losses that CBO anticipated. House Republicans will continue to highlight the implications to jobs and access as well as the skyrocketing cost of health care. Key implementation dates for 2013 and 2014 are as follows:
Higher Costs and Taxes
More Government, Higher Costs
Higher Costs/Lost Coverage/Lost Jobs/Employer Mandates
Decrease Access/Weakened Safety Net
 The Health Care and Education Reconciliation Act of 2010 amended certain provisions of PPACA through the reconciliation process.
 House Committee on Ways and Means, House Committee on Energy and Commerce and House Committee on Education and Workforce
 See House Committee on Energy and Commerce: Obamacare 101.
A CBO estimate is not available at this time. However, last year, CBO provided an estimate for H.R. 6079, the Repeal of Obamacare Act. According to CBO, “[a]ssuming that H.R. 6079 is enacted near the beginning of fiscal year 2013, CBO and JCT estimate that, on balance, the direct spending and revenue effects of enacting that legislation would cause a net increase in federal budget deficits of $109 billion over the 2013–2022 period. Specifically, we estimate that H.R. 6079 would reduce direct spending by $890 billion and reduce revenues by $1 trillion between 2013 and 2022, thus adding $109 billion to federal budget deficits over that period.”