Last week saw considerable drama in the Republican Congressional effort to repeal and replace the Patient Protection and Affordable Care Act (“ACA”).  Those efforts met a major stumbling block early Friday morning as Senators John McCain (R-AZ), Lisa Murkowski (R-AK), and Susan Collins (R-ME) joined Democratic Senators in opposing a “Skinny Repeal” bill in the Senate, seeming to end the Senate’s current consideration of the ACA repeal efforts.  In the attached memo, we describe the events that led to this surprising result, outline the substantive provisions that were considered, and discuss the four most likely paths forward in the short term.


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