Public Laws

American Health Care Act of 2017 [Obamacare Repeal]


The American Health Care Act of 2017 (AHCA) failed to pass Congress, despite support from the Leadership of both Chambers and the President. It has no settled form insofar as the version passed by the House never came to a final vote in the Senate, but that body could not find a majority of votes for any compromise amendment.

The primary goal of the Act was to repeal what has become colloquially known as “Obamacare”, which more formally is the enactment of two related bills: the Patient Protection and Affordable Health Care Act and the Health Care and Education Reconciliation Act of 2010.

The struggle over AHCA revolved over two main issues: In order to overcome a filibuster by Congressional Democrats, a supermajority of three-fifths is required in the Senate.  The idea of repealing the main domestic policy success of the Obama Administration has obvious partisan implications. Just as Obamacare was enacted without any Republican support, its repeal with get no Democratic support. This necessitated the use of a reconciliation, the expedited consideration procedural tool to allow a simple majority to enact legislation — as long as all the components of it have budgetary implications. A full repeal of Obamacare, since it wasn’t enacted that way, cannot be accomplished this way, but it can be largely eviscerated since a central aspect of the health care law is additional Federal subsidies to expand health coverage.

This brings up the second problem facing the bills: Once Obamacare is gone, what replaces it? For many Republicans and likely all Democrats, the answer of “nothing” was not viable. So threading that particular needle was where the entire enterprise ran aground (to neatly mix a metaphor).

In 2015, Congress passed a bill (H.R.3762) that repealed the President’s health care, he quietly vetoed it. The bill had circumvented the required three/fifths supermajority required in the Senate (60 votes) using the “reconciliation” legislative process. In 2017, the Republican Congress could not manage to get the bill to the desk of a President willing to sign despite using the same expedited reconciliation process. Why didn’t they simply pass the same exact bill they had in 2015? One wonders, but things change.

Coming down to the U.S. Senate, two Senators, Lisa Murkowski of Alaska and John McCain (of course), switched their votes from “yea” to “nay” this time around. The 2017 bill was not the same as the 2015 trial run, but perhaps the biggest difference was the fact that the second bill would have become law whereas the first was sure not to.

Senate Consideration

Senatory Mitch McConnell offered a full substitute amendment:

Obamacare Repeal Reconciliation Act of 2017 (SA267)  

General  Information

Bill Number:  H. R. 1628 (115th Congress)

Sponsor: Rep. Diane Black, Diane [R-TN]

Note: This was a reconciliation bill acted on pursuant to S. Con. Res. 3, the Concurrent Resolution on the Budget for Fiscal Year 2017. It reported by the House Budget Committee and passed by the full House on May 4, 2017. It was debated in the Senate, but failed to pass that chamber after debate on amendments concluded on July 28, 2017.

Text of Statute 

Amendment Text

Cong. Rec. (Senate July 27, 2017) S4440-S4604 (Web Link)

Obamacare Repeal Reconciliation Act of 2017 (SA267)  

CBO Cost Estimates

July 26, 2017 CBO Estimate for H.R. 1628, Better Care Reconciliation Act of 2017 – Enzi Substitute (CBO Pub #52977) – Requested by the Democratic  Staff, the Enzi Substitute (ERN17500).