On Friday, March 24, the American Health Care Act (“AHCA”), the bill to repeal and replace President Obama’s Affordable Care Act (“ACA”), failed to garner enough support in the House of Representatives for passage. Late Friday afternoon, Speaker Ryan announced that he – with agreement from President Trump – had pulled the AHCA from going to a vote in the House after confirming that an insufficient number of Republicans supported the legislation for it to pass. House Democrats unanimously rejected the AHCA. Prior to the decision to pull the AHCA for a vote by the full House, the future of healthcare in America was the center of a tumultuous week in DC.
Monday: On Monday evening, House Republications set forth amendments to the AHCA in an attempt to obtain enough support from conservative members for the bill. These amendments included (1) repealing the taxes that funded credits under ACA in 2017 instead of 2018; (2) allowing states to require non-disabled, childless individuals to work in order to receive Medicaid benefits; and (3) providing states the option to receive Medicaid funding as a simple block grant rather than as a per capita block grant.
Thursday: Last Thursday, on the seventh anniversary of President Obama signing the ACA into law, the House of Representatives was set to vote on President Trump and Speaker Ryan’s proposal to repeal and reverse the ACA. The vote was subsequently postponed to Friday.
Friday: In a last minute attempt to persuade members of the conservative Freedom Caucus to vote in favor of the AHCA, House Republican leaders apparently agreed for the legislation to eliminate, or at least severely limit, the essential health benefits provision of the ACA. This ACA provision requires all insurers to guarantee coverage for 10 essential health benefits, including maternity and newborn care, preventive health services, pediatric care, emergency room visits, hospitalization, ambulatory services, mental health and substance abuse services, laboratory services, prescription drugs, and rehabilitative services. Instead, the AHCA would have allowed states to determine which benefits must be included in every policy. Despite this revision to the bill, Speaker Ryan and President Trump could not obtain the requisite number of votes for the AHCA to pass the full House.
After Friday’s events, President Trump announced that he will move on to issues on his agenda other than healthcare. It appears that Speaker Ryan does not intend to push for a revised healthcare bill in the near future either, noting that for now, the ACA will remain the “law of the land.”