Attempts to replace the Affordable Care Act (ACA) suffered a major setback on Thursday as the U.S. Senate fell one vote short of a plan favored by the Republican majority and the President.

The “Skinny Repeal” proposal was less far reaching than a bill the House passed in May or that the Senate considered earlier in the month. It would have repealed the individual mandate and partially repealed the employer mandate and some of the taxes in the ACA.

The purpose of the proposal was to get a bill back to the House so an agreement could be worked out in a conference committee. Medicaid cuts like those offered in earlier versions could then have been added back to the legislation.

But the opposition on the final vote of every Democrat in the Senate plus three Republicans—Sen. John McCain, Sen. Lisa Murkowski, and Sen. Susan Collins—doomed the effort.

AHCA/NCAL President and CEO Mark Parkinson said providers made their voices heard on all the proposals that came before the Senate.

“We are grateful for our members who tirelessly defended our residents against the threats to Medicaid,” Parkinson said. “We appreciate and thank the members of Congress who heard their voices and voted to protect Medicaid. We will continue to encourage Congress to support and fund quality care for our nation’s most vulnerable citizens.”

Congress has now begun its annual August recess so no action from Congress is likely to take place this summer. The discussions continue, however, so it is important that providers remain engaged.


Legislators returned to the Capitol on July 18 for the first special session of the 85th Texas Legislature.

By law, the session can last up to 30 days. It is widely expected around the Capitol that they will take nearly if not all of those 30 days to complete their business.

Two weeks in, the Legislature most of the 20 items that Governor Abbott placed on the call for the session have not yet reached his desk.

Both chambers have passed the one “must pass” bill—Sunset legislation to keep several agencies, including the Texas Medical Board, in operation.

But the other items remain up in the air. The Senate thus far has approved 20 pieces of legislation relating to 18 items on the call. The House has passed eight bills related to four items.

One of the most high profile items on the call is the controversial “bathroom bill” which would ban transgender individuals from using bathrooms that match their gender identity. The Senate passed the bill on July 26 but it faces tougher sledding in the House, where Speaker Joe Straus has announced his opposition.

The Governor may call more special sessions if he chooses to do so. If not, the Legislature will not meet again until January, 2019.