ACA Watch May 1, 2017
Though previously pulled prior to a vote in March, the AHCA bill is still in conversation as Republicans make changes in hopes of it passing through Congress. Nothing has changed with the ACA, which remains the law today.
Government shutdown averted
Last week, Congressional negotiators were able to avoid a government shutdown through a short-term spending bill that keeps the government open for another week. Over the weekend there was bipartisan agreement to keep the government funded through the end of the September. The House and Senate are expected to vote on this longer term spending package this week. (USA Today)
“That dog ain’t hunting anymore”
The GOP remains uncertain of its ability to get the necessary number of votes from conservative and moderates who had previously opposed the AHCA bill.
According to Republican Representative Charlie Dent of Pennsylvania, “The business model around here is to load the bill up, make it as conservative as possible, send it to the Senate and have the Senate clean it up and send it back, and the very people who are placated on the first launch won’t be there on the final. And that dog ain’t hunting anymore.” (BenefitsPro)
GOP path forward?
A new draft of the American Health Care Act (AHCA) released last Wednesday was approved by the Freedom Caucus, increasing GOP optimism of a vote on the bill. Funding the government before the Friday deadline served as a reason for Republicans to try to push the AHCA through. However, on Thursday the GOP announced that they would not bring the bill to the floor until they were sure they had all the votes.
While efforts ultimately did not succeed, momentum has grown for an AHCA vote, with the amended AHCA draft winning over several of the bill’s skeptics. The Trump administration encouraged one last push to assemble a House vote on AHCA, in part to make true on GOP’s long-held promise to repeal or replace the ACA, but also to prevent the government shutdown.
Republicans will continue to look for ways to get the AHCA to the floor for a vote. Trying to balance the “wants” from conservatives and centrists has proven complicated. To pass the bill, the GOP could only afford to lose 22 votes. (BenefitsPro)
What does the amendment change?
The MacArthur Amendment to the AHCA would allow state waivers to opt out of certain ACA requirements. States could apply for waivers to reduce premiums, increase health insurance enrollment, stabilize markets, increase choice of health plans in that State, and stabilize premiums for people with pre-existing conditions. (ECFC)
The amendment got the official nod from the House Freedom Caucus. It also gained support by those previously opposed: Ways and Means Chairman Brady (R-TX), and Energy and Commerce Committee Chairman Walden (R-OR), and other influential conservative groups. (ECFC)
The amendment has also been criticized, for its treatment of people with pre-existing conditions. (BenefitsPro) The American Medical Association stated that the proposed change would result in coverage unaffordable for that population segment.
For employers, the AHCA could mean that group health insurance policies could cover fewer benefits. States who obtain a waiver to reduce essential health benefits could exclude certain benefits protected by the ACA. For instance, a state could decide that health insurance does not need to cover prescription drugs. (Venable)
Employer group health plans would also be able to obtain a waiver allowing them to impose an annual or lifetime limit on specific benefits. Such limits were previously not allowed under the ACA.
The Congressional Budget Office (CBO) has told Democrats that there would likely not be an updated estimate of the cost of the revised AHCA bill for several weeks. (BenefitsPro)
The AHCA still remains opposed by a few key players. The American Medical Association (AMA), American Hospital Association, and AARP still are in opposition. (BenefitsPro)
Some moderates in Congress have been skeptical as to whether the AHCA provides enough funding for state Medicaid programs. The ACA’s Medicaid expansion component has proven popular across party lines. The AHCA would phase out Medicaid expansion by 2020.
The AMA said in a statement, “The proposed change would still result in millions of Americans losing their health-care coverage and could make coverage unaffordable for people with preexisting conditions.” (BenefitsPro)
As a long-time member of the Employers Council for Flexible Compensation (ECFC), Employee Benefits Corporation will continue to provide ACA Watch updates as legislation continues to evolve.