Nationalized Health Care Report
Written by Editor   
Sunday, April 16, 2017 01:10 PM

A compilation of news reports about the ill fated American Health Care Act.

Recently House Republicans and the Trump Administration withdrew their bill to replace the Affordable Care Act when it became clear that they had not garnered enough votes to pass the controversial measure.  The House was finishing up its final debate on the bill, known as the American Health Care Act (AHCA), when a recess was suddenly called. The bill was ultimately pulled by the Republican leadership.  

The White House has appeared to be seeking a middle ground between the Freedom Caucus, a group of nearly three dozen members, and moderates who objected to full repeal of the Affordable Care Act. Some conservatives didn’t like the bill because of provisions such as the 30% surcharge on premiums for those who didn’t maintain continuous coverage, others took issue with the refundable nature of the tax credit. And some of the hard-line Republicans felt that the AHCA carried over too many of the old ACA regulations.  Moderates, on the other hand, were concerned about the impact of the bill on the near-poor — both those enrolled through the Medicaid expansion and those receiving the maximum subsidies on the exchanges -- and the drastic cuts to the Medicaid program.

In a closed-door meeting Vice President Mike Pence, Chief of Staff Reince Priebus, and Budget Director Mick Mulvaney laid the plan before members of the House Freedom Caucus. Under the new White House plan, states could apply for federal waivers to gain relief from certain ACA coverage requirements including one that prevents insurers from charging higher premiums for sicker individuals.  The proposal would also allow states to opt out of the mandate that all insurers offer “essential health benefits” such as maternity care, prescription drugs, mental health treatment and substance use disorder treatment.  It would also add $15 billion to the Patient and State Stability Fund, a $100 billion fund that lets states decide how to deploy funding for healthcare. The extra funds were earmarked for maternity care, newborn care, substance use disorder treatment and mental health treatment.

Speaker Paul Ryan conceded, “doing big things is hard. All of us, myself included, we will need time to reflect on how we got to this moment and what we could have done to do it better.  I’m really proud of the bill that we produced. It would make a dramatic improvement in our healthcare system and provide relief [for] people hurting under Obamacare. What’s probably most troubling is the worst is yet to come with Obamacare.”

Texas congressional representatives noted that “Obamacare is a sinking ship and it’s taking a lot of good people down with it,” said Rep. Kevin Brady (R-Texas).  The Republican bill would "unburden" Americans of the mandates and taxes imposed by the ACA that Americans "don't want and can't afford," said Brady during a Rules Committee hearing just prior to the floor vote.

Rep. Pete Sessions (R-Texas), the House Rules Committee chairman, further described the current insurance regulation as a “self-defeating spiral of rising costs and less options” and “a government-created monopoly."  He noted that 19.2. million Americans chose to pay the individual mandate penalty or take an exemption rather than enroll in Obamacare plans.

As proposed, the AHCA eliminates the taxes and mandates that financed the ACA — including the individual and employer mandate penalty — allows insurers to charge older adults and young people less, and replaces subsidies based on need with flat tax credits based primarily on an age.

The American Chiropractic Association (ACA) said in a statement that it acknowledges the difficulties associated with implementation of the Patient Protection and Affordable Care Act (PPACA), passed in 2010. Many exchanges are down to only one plan available to consumers and premiums have skyrocketed since the law has been in effect.

“The bill considered today by the U.S. House of Representatives needs further work to truly enhance patient access to affordable conservative care,” said ACA President David Herd, DC. “The American Chiropractic Association is particularly concerned with the repeal of the essential health benefits provision within PPACA, which outlines the list of benefits plans in the exchange and the private markets must contain. Our greatest concern is that the only affordable plans that will be available will contain minimal coverage, limiting patient access to chiropractors and other providers who offer non-drug, noninvasive conservative approaches to health care.”

It is uncertain at this time when Congress will again look to repeal and replace all or parts of PPACA.  “There was little opportunity for stakeholder input throughout this process,” Dr. Herd stated. “We remain ready to work with the Administration and Congress on issues to protect the millions of patients who have coverage and to ensure access to cost-effective, conservative treatments provided by doctors of chiropractic.”

President Trump brushed off the recent collapse of a House-led bill to repeal and replace Obamacare.  Instead, he said that he expects to do a deal on health care sooner rather than later, “I have no doubt that’s going to happen very quickly.”

Experts have opined that the House Republicans’ proposal to replace the Affordable Care Act appeared to be doomed from the start.

There was little upside to this bill, It threatened to further destabilize the individual insurance market, and the savings to the federal government were modest. It is hard to have a coherent reform that does not address all aspects of the ACA. The House Republican majority ended up with multiple goals and multiple objectives, and that’s why you don't have a unified majority.  Congressional leaders should use this opportunity to start over with a bill that truly repeals Obamacare and move forward in a transparent process.

Several physician groups applauded the bill’s defeat. “A major crisis was averted today when leaders of the House of Representatives pulled the vote for the American Health Care Act [AHCA] — legislation that would have had a significant and devastating impact on the health and well-being of all Americans, especially women and families," the American Congress of Obstetricians and Gynecologists said in a statement.

“With the House decision not to proceed with a vote on the American Health Care Act, patients across America got a reprieve from the harmful effects it would have had on both their health security and financial security,” the American Academy of Family Physicians, said in a statement. 

“It is essential that this bill -- and the many harmful policies in it -- be put aside for good," the American College of Physicians said in a statement. "Specifically, Congress should once and for all abandon any effort to cap the federal contribution to Medicaid or block grant the program ... repeal essential evidence-based benefits, or replace the Affordable Care Act's income-based premium and cost-saving subsidies with regressive age-based ones that will raise premiums and deductibles for most Americans, and especially, for older, poorer and sicker patients."

The bill's failure "leaves ... the Trump administration with the responsibility of rescuing the individual insurance market