The Affordable Care Act was a primary focus of the 10th annual Kansas Health Law Institute, which drew representatives of hospitals and physician offices from throughout the state.
Those at the institute, held Friday in Wichita and hosted by the Foulston Siefkin law firm, seemed to agree that it was unlikely that the law would be completely repealed – even under a Republican president and Congress.
The law was approved in 2010, when Democrats controlled the White House and Congress. It has become a campaign issue on the state and national level, and Republican nominee Mitt Romney has vowed to repeal the law if he’s elected president.
He’s also said, however, that he will keep some provisions of the act.
Johnathan Rhodes, a Foulston Siefkin health care attorney from the firm’s Topeka office, outlined what steps would have to occur for the act to be repealed altogether.
Rhodes said he thinks the Republicans will need a “GOP trifecta” in November to fully repeal the Affordable Care Act: a Romney win, a House majority and more than 60 members of the Senate, which would be “filibuster-proof.”
However, he noted that a budget reconciliation bill would allow Congress to repeal certain provisions of the law, in particular those that rely on funding that could be withheld in a budget bill. Those provisions could include such things as health exchanges and subsidies designed to help lower-income Americans buy health insurance.
“Really anything that affects the federal budget is something that could be either removed or added with reconciliation,” Rhodes told the institute attendees. “The key with reconciliation is that those provisions can be removed or added with a simple majority of the Senate. So they really would only need 50 seats in the Senate to do that, 50 because any tie would be broken by the head of the Senate, which is the vice president.”
Rhodes said that Paul Ryan, the Republican candidate for vice president and a current member of the U.S. House, has said that 85 percent of the law could be, in effect, repealed through the budgeting process.
Rhodes said that the Senate parliamentarian would decide if a particular provision was fiscal or regulatory, he said.
“Even with the recent debates I think you saw the Republican candidates laying the groundwork for that position,” said attorney Scott Palecki, who practices health law at Foulston Siefkin’s Wichita office.
Marta Fisher Linenberger, another Foulston Siefkin health attorney from Topeka, said in an interview that she thinks certain provisions would likely remain in place under Romney. She cited the provision that requires insurance companies to allow adults younger than 26 to remain on their parents’ insurance, requirements regulating the coverage of people with pre-existing conditions and regulations regarding lifetime limits for benefits.
Depending on who wins, she said, there also could be changes in the provisions that deal with women’s reproductive health issues.