2017-05-17 14:11:31 UTC

House Approves the American Health Care Act to Repeal Obamacare

May 17, 2017

Patient access to quality health care, preventive screenings and specialty care are AGA priorities.

The House passed an updated version of the American Health Care Act (AHCA) by a vote of 217-213, with all Democrats and 20 Republicans opposing the bill, and one Republican not voting. The Republican leadership brought the bill to the floor using the budget reconciliation process, which only requires a simple majority in both chambers and prevents the use of a filibuster in the Senate. 

A month earlier, the Republican leadership pulled the bill from a vote, since they did not have the necessary votes to pass; however, Rep. Tom MacArthur, R-NJ, a moderate Republican, worked on a compromise to bridge the divide between the moderates and the more conservative Freedom Caucus wing of the Republican party. 

The Compromise Provision 
Under the compromise, states will be allowed to opt out of the Affordable Care Act (ACA) insurance reform requirements if they develop an alternative plan to lower premiums for people. In opting out of these requirements to not charge patients with pre-existing conditions more for coverage, states would set up high risk-pools to help patients buy insurance. However, many critics have argued that high-risk pools are often underfunded and are not able to cover patients with pre-existing conditions, who are often costlier to insure. Rep. Fred Upton, R-MI, brokered a deal to add an additional $8 billion to the high-risk pools to assuage concerns that patients with pre-existing conditions still wouldn’t be able to afford coverage. With these changes, the Republican leadership passed the AHCA.         

AGA Advocacy 
AGA remains concerned that patients who received coverage through the ACA will lose coverage, will not have access to specialty care and will not receive coverage for preventive screenings without cost-sharing, such as colorectal cancer screenings. We are concerned that repeal legislation, like the AHCA, will result in millions of patients being uninsured and millions of dollars in uncompensated care to providers, like gastroenterologists. AGA will continue to monitor the legislative process and voice our concerns. Learn more about how you can get involved through the AGA Political Action Committee.

The Senate Bill
Passage in the House is the first step in a long legislative process. The Senate has stated that they will start from scratch and draft their own bill, since many Republican Senators have expressed strong reservations about the AHCA. The Senate also wants to know the cost of the AHCA and how many people will be covered and/or lose coverage since those figures were not available at the time of the House vote.  

Although Republican Majority Leader Mitch McConnell, R-KY, has assembled a working group on health-care reform, Sens. Bill Cassidy, R-LA, and Susan Collins, R-ME, are pushing an alternative proposal that would essentially keep the ACA intact for those states that have set up exchanges and want to preserve it. It will also allow states to set up their own proposals, which could be more market-based, but they would keep the insurance reforms intact. Both Sens. Cassidy and Collins are hopeful that their proposal will garner bipartisan support and eventually broader public support. Regardless, the Senate will likely not vote on any measure until at least the summer, which will likely look much different from the AHCA that passed the House.