3:10 P.M. The Competitive Health Insurance Reform Act passed the House this afternoon, 416-7.

The House will vote today on two bills that will initiate phase three of the effort to repeal and replace the Affordable Care Act (ACA). Phase one began two weeks ago with the bumpy rollout of the House GOP’s American Health Care Act (AHCA), which is scheduled for a House vote tomorrow.


Congressional GOP leadership and the White House have insisted throughout the wrangling over the ACHA that, if the bill is passed, it will be followed by two more “phases” of executive and legislative action to further address the flaws of the ACA. The second phase will be managed by Health and Human Services Secretary Tom Price, who hopes to use his administrative authority to ease some of the regulations imposed by Obamacare that cannot be addressed by legislation.

The third phase will be made up of several pieces of legislation that cannot be passed in Congress through budget reconciliation. This is a process that allows a bill to pass the Senate with a simple majority, and it is the process that GOP leadership is currently using in the hopes of passing the AHCA. Because of the limits of the budget-reconciliation process, the AHCA can only address certain aspects of Obamacare, those having to do with taxes and spending.

The two bills that the House will consider today — the Small Business Health Fairness Act (H.R. 1101) and the Competitive Health Insurance Reform Act (H.R. 372) — are the first pieces of legislation introduced as part of phase three, and they target aspects of Obamacare that cannot be altered by the AHCA.



The Small Business Health Fairness Act will take the first steps toward allowing the purchase of health insurance across state lines. It will permit small businesses from different states to band together and negotiate with insurance providers, giving them leverage and placing them on more equal footing with large employers and unions.

According to House leadership, 95 percent of small businesses have faced increasing health-insurance costs over the past five years, and 10,000 small businesses have been forced to shut down as a result. The provisions of H.R. 1101 would allow for a greater range of health-care options, which would enable middle- and low-income families to purchase insurance through their employers at a lower cost.

The second bill, H.R. 372, would reform the McCarran-Ferguson Act, which currently exempts insurance companies from some federal anti-trust laws. Repealing these exemptions would restore competition in the health-care industry, lowering costs for hospitals, doctors, and patients. House leadership suggests that this bill would lower premiums by limiting market consolidation and making a variety of low-cost options available for more individuals and families.


The White House has indicated that President Donald Trump would sign either of these two bills, if they should reach his desk. The House’s consideration of these bills today takes place in the shadow of ongoing debate over the AHCA, and the fate of that bill remains unclear just one day before voting.