AHCA Passed By House Republicans

AHCA Passed By House Republicans

By a narrow vote of 217-213, the House of Representatives passed the American Health Care Act (ACHA) on May 4th, 2017. AHCA is essentially a repeal and replacement of the Affordable Care Act. An earlier scheduled vote in March failed to gain the support needed to pass, and House Republicans spent weeks working to bring holdouts onboard with the idea. It was initially unclear as to whether or not AHCA would even be revisited by congress, but upon gaining the traction needed the bill was reintroduced.

With President Obama no longer in the White House, the risk of health care reform bills from Republicans being vetoed by the president became unlikely and since the inauguration of President Trump the repeal of ACA has been a major focal point for the republican party.

There were two main factions of the Republicans in the house that opposed the original form of the AHCA – the House Freedom Caucus and the Tuesday Group. The opposition from these two groups meant that the bill was unlikely to pass. But ACA reform and the elimination of the so-called ‘Obamacare’ laws have been key parts of campaign promises from the House and Senate republicans ever since it was put into place in 2010.

To help gain the support of these two holdout factions, two amendments were introduced. The first amendment allowed states to be eligible to apply for waivers from certain standards of the ACA – particularly the health benefit requirements and certain community ratings rules. This amendment still prohibits refusal of insurance to individuals with pre-existing conditions and prohibition of risk rating enrollees based on their gender.

However, states can waive these requirements if a high-risk pool program is in place. These pool programs are intended to provide subsidized coverage for the individuals who may face higher premiums due to be classified as ‘high risk’.

The second amendment adds an additional $8 billion in funds to provide subsidized insurance for those who do have preexisting health conditions. This extra funding is authorized to be available until 2023 and is only accessible to those states that obtain the community rating waiver set forth in the first amendment.

With these two amendments added to the bill, the AHCA was finally able to be approved by the House by a small margin. Now, the bill moves to the senate for review. It’s expected that there will be a similar bill devised by members of the senate, after which the two bodies will begin negotiating a compromise that will move the AHCA into its final form. In order to avoid a filibuster by Senate Demograts, the Senate version of the bill will be passed, if at all, as a budget bill. Then it go through a budget reconciliation process and presented to both chambers for an up or down vote. In other words, there is a good chance that the finalized AHCA that becomes law will undergo substantial changes from the current House version.

It’s also worth remembering that this legislative effort is only a single part of a three-part strategy for repealing the ACA. The Trump Administration is already planning on rewriting and revising hundreds of different rules and regulations related to the ACA over the next four years. These will focus on the provisions that congress can’t target through its own efforts.

The bottom line is that while AHCA is moving forwards quickly, it’s likely only the beginning of this administration’s health care reform.

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