The Senate adopted a fiscal year 2017 budget resolution that includes reconciliation instructions for repealing the Affordable Care Act (ACA), the landmark 2010 health care law. The 51-48 vote was mostly along party lines, with Senator Rand Paul (R-KY) the only Republican to vote against the measure. The vote came hours after a marathon debate on various amendments, mostly related to health care. One amendment was introduced to undermine HUD’s Affirmatively Furthering Fair Housing (AFFH) rule, but was not voted on.
Under budget reconciliation, congressional committees are given instructions to develop legislation to achieve particular budgetary results through changes to mandatory spending, tax revenue, or the debt ceiling. Republicans seek to repeal the ACA’s provisions that affect spending and taxes. When these reconciliation bills reach the Senate floor, only a simple majority of senators will have to vote for the bills to gain passage. For other bills, a 60-vote majority is often needed to end debate and move to a final vote. Senate Republicans have a thin 52-48 majority over their Democratic colleagues.
The ACA, with its expansion of the Medicaid program, has become a vital tool in helping address homelessness in America. Often suffering from serious physical and mental health issues, chronically homeless individuals are heavy users of expensive emergency health, hospital, and even criminal justice systems and services. Advocates argue that Medicaid expansion and supportive housing can work together to reduce chronic homelessness in a deficit neutral way by combining affordable and permanent housing with case management, primary and mental health care, substance abuse treatment, employment, and other services that help people achieve stability and independence rather than being forced to rely on more expensive, less effective interventions.
Senator Mike Lee (R-UT) offered the amendment to undermine HUD’s AFFH rule, but the Senate did not vote on it. Mr. Lee offered a similar amendment last year during Senate consideration of the FY17 Transportation-HUD spending bill.