The House on Thursday approved a bill to repeal and replace major parts of the Affordable Care Act. The vote, 217-213, came on President Trump's 105th day in office and dismantles key ACA provisions such as essential health benefits and pre-existing condition protections.
According to Healthcare Dive, the revised AHCA drastically changes the individual insurance market as well as the Medicaid program. As currently written, Medicaid expansion would be phased out and the public program would take a $880 billion hit over 10 years. The House bill would eliminate tax penalties for people who go without health insurance and allow state governments to seek waivers that would let insurers charge higher premiums for customers with pre-existing medical conditions. Those changes could be rejected by moderate Republican senators.
President Donald Trump held a press conference after the vote and said he is confident the bill will pass in the Senate. This is far from assured and many influential industry associations such as the American Hospital Association (AHA) and the American Medical Association (AMA) oppose the AHCA.
“The bill passed by the House today will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question," AMA President Andrew Gurman stated after the vote.
The House vote on Thursday occurred before the Congressional Budget Office had released a new analysis of the revised bill with its cost and impact. MJ Lee with CNN reports Democrats questioned how Republicans could vote on a bill that would affect millions of people and a large slice of the American economy without knowing the ramifications.
The bill next goes to the Senate, but according to Healthcare Dive it is not clear whether the GOP has the votes in that chamber without major changes. Sen. Lamar Alexander (R-TN), the chairman of the health committee, said in a statement Thursday that GOP senators are working on their own bill and “will take the time to get it right.” Others in the Senate have said there is no clear timeline for moving forward with efforts to repeal and replace the ACA.