Analysts at S&P Global Ratings are expecting traditional federal checks and balances to shape efforts to change or replace the Affordable Care Act.
Joseph Marinucci, a senior director at the New York-based rating agency, said Tuesday that he believes Republican opponents of the law will need time to come up with repeal, change or replacement legislation that can get through the Senate.
"Repeal is easy," Marinucci said in New York at a presentation on S&P's outlook for the U.S. health insurance sector. "Replace is hard."
The Republicans hold 52 seats in the Senate.
Senate traditions normally require supporters of a bill to attract at least 60 votes to get a bill or nomination to the floor of the Senate.
A federal law lets senators get budget measures through the Senate with just 51 votes. The law gives jurisdiction over what can go into a budget measure to the Senate parliamentarian.
James Sung, an associate director at S&P, said he believes those procedural rules will continue to shape the ACA replacement effort. If those rules stay in place, Republicans will need to win some support from Democrats and independents to do anything other than de-fund major ACA spending programs, or change major ACA tax and penalty provisions.
Marinucci predicted that federal policymakers are unlikely to get any ACA overhaul or replacement in place until 2019.
"There's a lot to this," Marinucci said.
