Dive Brief:
- House Republicans have scheduled a vote Thursday afternoon for the American Health Care Act (AHCA), which rolls back multiple key provisions of the Affordable Care Act, such as essential health benefits, protection for people with pre-existing conditions and bans on lifetime and annual caps.
- The updated bill does not have a score from the Congressional Budget Office, but a previous version was estimated to remove coverage for about 24 million people.
- The bill also includes major cuts to Medicaid and the phasing out of Medicaid expansion as well as tax credits based on age, not income, and loosens restrictions on payers for charging older enrollees more than younger ones.
Dive Insight:
The AHCA is still opposed by nearly every major group in the healthcare industry, including the American Medical Association (AMA) and the American Hospital Association. Other heavy hitters such as the AARP have also come out against the bill.
“None of the legislative tweaks under consideration changes the serious harm to patients and the health care delivery system if AHCA passes," AMA President Andrew Gurman said in a statement. "Proposed changes to the bill tinker at the edges without remedying the fundamental failing of the bill — that millions of Americans will lose their health insurance as a direct result of this proposal."
The most recent convert was the influential Rep. Fred Upton (R-MI), who switched to a yes after tweaking an amendment so that it would include high-risk pools and fund them with $8 billion. Multiple health policy experts, however, say that would not be nearly enough to adequately protect people with pre-existing conditions.
GOP leaders say they are confident they have the votes to pass the bill, but independent whip counts show it’s likely to go down to the wire with both moderates and hard-line conservatives on the fence.
After a public defeat in March, when House Speaker Paul Ryan pulled the bill at the last minutes because it did not have the votes to pass, many have taken to referring to the bill as a “zombie” because of its tendency to come back into consideration just when it seems to be done for good.
Republicans are still eager to make good on their frequent promise of repealing the ACA. The cascade of delays, however, show the political difficulties of removing coverage from millions of people and leaving those who have pre-existing conditions with drastically fewer protections.