Is ObamaCare debate starting to thaw?

In a nearly empty House chamber on Monday afternoon, a little-noticed bill came up for a voice vote. The few lawmakers on the floor shouted “aye,” no one shouted “no,” and the bill was passed.  

Changing ObamaCare has rarely been so drama-free.

{mosads}Passage of the bill, which would adjust the healthcare law’s definition of a small employer, is raising hopes that more bipartisan tweaks to ObamaCare could be on the way. 

“I do believe that this hopefully is the beginning of a lot of little fixes to a big, big law that’s not perfect,” said Rep. Tony Cárdenas (Calif.), a lead Democratic sponsor of the bill. 

Democrats have long accused Republicans of being unwilling to make even minor fixes to the healthcare reform law, arguing the party’s fixation on repeal was standing in the way.

But after a Supreme Court decision over the summer that kept ObamaCare intact for a second time, legislative tweaks are getting a second look.

The bill from Cárdenas and Rep. Brett Guthrie (R-Ky.), called the Protecting Affordable Coverage for Employees (PACE) Act, deals with an obscure provision in ObamaCare that changed the definition of a small employer from one with 50 employees or fewer to one with 100 employees or fewer, beginning in 2016.

The change would force businesses with 51 to 100 employees into the small-group insurance market, where they would face new coverage requirements, likely pay higher premiums, and could lose their current plans.

The PACE Act undoes that change, while giving the states the option to expand the small-group insurance market if they want. 

It isn’t the first ObamaCare revision to pass Congress; in 2011, lawmakers voted to eliminate extra paperwork that businesses were going to have to file with the IRS.

But with the law entering its third enrollment period and growing more entrenched, some lawmakers are hoping for a shift in the legislative debate.

Senate Finance Committee Chairman Orrin Hatch (R-Utah), a top player in healthcare issues, said the House’s action on the small-employer bill could move things forward. 

“Anything that will help bring about any kind of bipartisan transformation gives me hope, because I think that was an interesting move by the House,” Hatch said.

“I think we’re looking for full repeal, but we’re also looking to see if we can get Democrats to do something on some of the partial corrections as well.”

Still, the partisan battles over the law are far from over.

House Republicans are moving full steam ahead with bills under the fast-track process of reconciliation that would repeal several core elements of ObamaCare, including its mandate that people buy insurance or pay a penalty. 

Republicans can also frame the PACE Act as chipping away at the law rather than seeking to improve it.

Still, the lack of controversy around the bill is notable.

“I’m hoping it will be the first in a slew of opportunities to improve the Affordable Care Act and make it more palatable for businesses,” said Katie Mahoney, executive director of health policy for the U.S. Chamber of Commerce. 

The Chamber of Commerce, which opposed the passage of ObamaCare, says the law is now too ingrained to be repealed and is pushing Congress for fixes. 

One of the business group’s top priorities is repeal of the 40 percent “Cadillac tax” on high-cost health plans, which is set to take effect in 2018. The tax has also drawn opposition from unions, who are concerned it will curtail employee benefits.

Democratic presidential front-runner Hillary Clinton announced her opposition to the Cadillac tax on Tuesday, which is part of her push to repair, and not replace, ObamaCare.

Clinton has yet to take a position on another ObamaCare fight: the bipartisan push to repeal the healthcare law’s excise tax on medical devices.

The White House has defended the Cadillac tax and has outright threatened to veto a bill repealing the medical device tax, but the small-group change under the PACE Act could be different. 

The White House has not yet issued a position on the bill, known as a statement of administration policy. 

Sen. Tim Scott (S.C.), the lead Republican sponsor, said the PACE Act could move forward in the Senate “in the next week or so” and that there is “some momentum” for bringing it straight to the floor and skipping the committee process.

Cárdenas said his impression is that the White House welcomes the bill. He expects Obama will sign it, though without fanfare. 

“It doesn’t look like they’re going to do a lot of pomp and circumstance,” he said.