The Three Phases of Repeal and Replace | Speaker.gov

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From the start, we have been taking a step-by-step approach to repeal and replace Obamacare. Because building a better, patient-centered system is going to take more than just one bill.

As Speaker Ryan explained at his press conference, this approach has three overarching phases:

  • The American Health Care Act, which takes full advantage of the budget reconciliation process to avoid a Democratic filibuster;
  • Administration actions, notably by HHS Secretary Price, to stabilize the health insurance market, increase choices, and lower costs; and
  • Additional legislative policies, such as allowing individuals to purchase coverage across state lines, that by Senate rules cannot be included in a reconciliation bill.

Here’s how Speaker Ryan put it:

“Let me describe to you what the three phases are…Number one is this bill, which we use as reconciliation. As you all know, you can’t filibuster a reconciliation bill so this repeal and replace bill is what we pass through reconciliation…Phase two: all the regulatory flexibility that the Secretary of HHS has to deregulate the marketplace to lower the cost and stabilize the marketPhase three is to pass the bills that we want to pass that we cannot put in reconciliation because of those budget rules. What’s an example of that? Interstate shopping across state lines. We love that policy, we think it’s critical, but as you well know, you cannot put that in a budget reconciliation bill.”

Here is what Secretary Price wrote in his letter to congressional leaders:

Achieving all of the President’s goals to reform healthcare will require more than what is possible in a budget reconciliation bill, as procedural rules on this type of legislation prevent inclusion of key policies such as selling insurance across state lines, lowering drug costs for patients, providing additional flexibility in Medicaid for states to manage their programs in a way that best serves their most vulnerable citizens, or medical legal reforms.”

Secretary Price has also outlined the additional phases here

With Congress considering reconciliation legislation, the Department of Health and Human Services (HHS) continues its work on the next two steps: taking administrative actions that will create a healthier insurance market and alleviate the burden the current healthcare law imposed on Americans, and supporting work on legislation that will include reforms not permitted under reconciliation, such as purchase of insurance across state lines.

Learn more about the American Health Care Act here.