In the past few months, healthcare news has been everywhere.  Congressional Republicans have been working hard to keep their promise to repeal the Affordable Care Act (ACA).  The latest effort, culminated in a few nail-biting votes in the Senate that ultimately rejected any effort to repeal the ACA.  You may be wondering what’s next?  Will there be additional efforts to replace the ACA?  When?  What other considerations should we all be aware of?

We asked three leading healthcare attorneys what they make of the Republicans’ recent efforts to repeal the ACA, and what strategy they think Congress will devise next.  Unsurprisingly, they’ve got some keen legal insight and words of wisdom to share.

Steven Chananie, a partner in Sheppard Mullin’s healthcare practice, notes that despite all the recent turmoil, there are still two large questions Congress hasn’t answered.  First, Congress must address how we can lower healthcare costs, while still providing quality medical care.

According to Steven, there are many examples throughout the country that Congress could replicate to lower healthcare costs, such as:

• spending more on necessary social supports for patients at risk;
• devising and implementing alternative reimbursement models (both governmental and commercial), with incentive components coupled with enhanced coordination of care efforts;
• innovate population health and disease management initiatives; and
• new kinds of joint ventures and other types of affiliations to ensure better and less costly continuity of care across providers and the care continuum.

He also presents a second fundamental question that he believes Congress has yet to address: “to what degree does the country believe that ensuring affordable healthcare for everyone is a truly a priority?  Now that tens of millions of previously uninsured people have coverage under the ACA (through Medicaid expansion, the marketplaces, preexisting condition coverage or otherwise), it is difficult to remove that coverage and leave them uninsured again or with diminishing options.”  Thus far, maintaining affordable healthcare for the millions of people who acquired health insurance under the ACA has proved to be irreconcilable with any repeal of the ACA or Medicaid expansion.

Steven sums it up well when he says, “Congress is grappling with difficult and perhaps insurmountable challenges in the present political climate, but their efforts – win, lose or compromise – may be missing [these] essential and larger point[s].”

So, with all of these challenges, what does the future of the Affordable Care Act look like? Douglas Grimm, healthcare partner at Arent Fox in DC, looks to the past to foretell the future:

“In 2015, the Republican majority in the Senate approved a bill repealing the ACA in its entirety.  Though the bill was ultimately vetoed by then-President Obama, the vote laid the foundation for the Senate’s recent repeal efforts…. [I]f the Republicans succeed, a significant number of people will lose insurance. In addition, regulation of insurance will return to the states, leaving individuals in states with little regulation few consumer protections.”

Hillary Stemple, also a healthcare attorney at Arent Fox, added:

“[W]ith enough Republicans refusing to vote for the bill, it’s possible we may [now] see a bipartisan approach to ‘fix’ the ACA, including legislation to help shore-up the individual marketplaces, and additional cost-sharing payments to the insurance companies offering plans on the state exchanges.”

Want to learn more about what might be in store? Watch Steven Chananie’s CLE program What Comes Next: A Post-Election Analysis of the Affordable Care Act, or catch Douglas Grimm and Hillary Stemple in The Affordable Care Act: What Happens Now?