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Romney signs pledge to repeal ACA

Posted on July 26, 2012 | No Comments
Filed under Legal Challenges

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Republican presidential candidate Mitt Romney signed a pledge yesterday to repeal and defund the Affordable Care Act (ACA). Although Romney has consistently vowed to repeal “Obamacare” if elected, many conservatives question his dedication to this commitment given that the presidential candidate passed a very similar health care law during his tenure as governor of Massachusetts. The pledge states: “I would now and will for the duration of my presidency, promote and sign all measures leading to (the law’s) defunding, deauthorization, and repeal.”

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The Congressional Research Service issued a report summarizing legislative actions to repeal, defund, delay, or amend the Affordable Care Act (ACA). The report compiles legislation that has been approved by both chambers and enacted into law, legislation passed in the House not considered by the Senate, and ACA-related provisions in enacted annual appropriations acts for each of FY2011 through FY2014. Also included is a brief overview of all the ACA-related provisions added to appropriations bills considered, and in most cases reported, by the House and Senate Appropriations Committees since FY2011.
President Obama and Governor Romney offer different visions for the nation’s healthcare system. To inform public discussion about health care in the election and beyond, an analysis published by the Commonwealth Fund draws from microsimulation analysis to contrast the potential impact of implementing the Affordable Care Act (ACA) in full with Romney’s proposals to repeal the law, eliminate many of the new requirements for insurance markets, and make changes in Medicaid and Medicare. The report focuses on the following:
  • the number of Americans expected to gain health insurance;
  • changes in the affordability of insurance;
  • changes in consumer protections and consumer choice;
  • help for small businesses;
  • improvement in Medicare solvency;
  • improvement in health care quality; and
  • control of health spending growth.
The report's findings indicate that, in each area, implementation of the Affordable Care Act would likely outperform Romney’s proposals.
President Barack Obama and former Massachusetts Governor Mitt Romney released essays in the New England Journal Medicine (NEJM) presenting their visions for the future of health care reform. Obama calls for additional steps to fix the nation's health care delivery system, including a "permanent fix to Medicare's flawed payment formula that threatens physicians’ reimbursement.” President Obama also pledges his commitment to life sciences research, distancing himself from vice presidential candidate Paul Ryan's proposal to slash medical research investments. Obama also touts various popular Affordable Care Act (ACA) provisions including the end of lifetime benefit caps, expanded preventive care services coverage, permitting young adults to remain on their parents insurance until age 26, rebates from insurance companies from the medical loss ratio (MLR) provision, and the efforts to reduce Medicare and Medicaid fraud. Romney touches on his premium support plan for Medicare, Medicaid block grants, and plan to prevent discrimination against patients with pre-existing conditions "who maintains continuous coverage."
"The Path to Prosperity: Restoring America's Promise" is the House Budget Committee's Fiscal Year (FY) 2012 budget resolution. The sections "Strengthening the Social Safety Net," and "Fulfilling the Mission of Health and Retirement Security for All Americans," encourage government to repeal and defund the Affordable Care Act (ACA), offering instead a reform proposal that builds upon the Rivlin-Ryan Medicare reform plan advanced in the President's Fiscal Commission in 2010. The FY2012 budget resolution proposes to 1) convert state Medicaid funding into a block grant, 2) offers Medicare beneficiaries the same health care options as members of Congress, 3) calls for the advance of social security solutions.
On September 28, 2011, the United States Justice Department (DOJ) asked the United States Supreme Court to review the decision of the court of appeals for the Eleventh Circuit striking down as unconstitutional what the DOJ terms the law’s “minimum coverage provision.” In seeking Supreme Court intervention, the DOJ sought review on two matters: first, whether Congress exceeded its Commerce Clause powers, as enhanced by the Necessary and Proper Clause; and second, whether the Anti-Injunction Act bars the challenges from proceeding in the first place.
Since the enactment of the Affordable Care Act (ACA), at least 27 lawsuits have been filed challenging the constitutionality of various provisions of the law. While nearly half of the lawsuits have been dismissed on procedural grounds, three district courts have found provisions challenged to be constitutional, and three have found them to be unconstitutional. Previous HealthReform GPS Implementation briefs/updates have discussed these lower court decisions. Following appeals of each of these rulings, the United States Courts of Appeals in the Fourth, Sixth, and Eleventh Circuits have now issued decisions as well. Most importantly, the appellate decisions continue to reflect a split in judicial opinion regarding the constitutionality of the Affordable Care Act’s individual mandate. Other important issues addressed by the appellate rulings concerned the constitutionality of the ACA Medicaid expansion and the question of whether the trial court in the Virginia cases (Liberty University v. Geithner and Commonwealth of Virginia v. Sebelius) had the authority to hear the cases at all.
As discussed in the GPS Health Reform Overview, the Affordable Care Act (ACA) imposes penalties on large employers who do not offer affordable insurance to their employees if those employees receive subsidies to purchase insurance elsewhere. For certain employees, the ACA required employers to provide a voucher for purchase of insurance through a state Health Insurance Exchange. However, this “Free Choice Voucher” requirement was repealed on April 15, 2011, as part of an appropriations bill.
Section 9006 of the Affordable Care Act (ACA) would have required businesses to issue 1099 forms for transactions over $600 with other corporations, such as vendors and suppliers. This was a significant expansion of the reporting requirements and was seen by many as a huge burden on businesses, particularly small businesses. On April 14, 2011, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011 was signed into law, repealing the ACA Section 9006 reporting requirements.