Last week, Paul Ryan attempted to make good on the Republican campaign promise to change the existing health care legislation by passing the American Health Care Act (AHCA) through the House. How did they do that, and what happened?
Campaign Promises, Revised
It began as a simple two-word promise: Repeal Obamacare. This uncomplicated desire to repeal the Affordable Care Act (ACA) quickly became very complex. Constituents who make up a significant part of the Republican base were utilizing and loving the ACA, even while disparaging Obamacare. This problem of branding has not been entirely overcome, but significant strides in making insurance available to freelancers, those who make just too much for Medicaid, and those with preexisting medical conditions. (It also makes sure women aren’t charged more, and that there is a limit on increasing premiums as age increases. These benefits became clearer and clearer, and people began to expect government assistance in obtaining health insurance. Hence, a Republican move towards “Repeal and Replace.”
No Democratic Support
The Democratic party is up for expanding Medicaid, adding a private option, and improving the flaws in the ACA. Scrapping what is perhaps the definitive work of Barack Obama’s presidency and helped many of their constituents was not on their agenda. The fact that no Democrats voiced support of the AHCA is a look into the partisan nature of today’s political climate.
Rushing
The ACA was introduced more than a year before it was passed, and had various hearings and was revised numerous times to get passed. This bill was introduced in early March and the vote was supposed to happen last week. The Congressional Budget Office’s (CBO) score was released the next week, with the figure that 24 million people will lose insurance by 2020 if the new plan passes. The vote was scheduled for last Thursday and was then rescheduled for Friday.
Too Divisive for Republican Support
The CBO score, combined with constituent engagement and polls of support at 17%, led to many moderate Republicans to voice their intent to vote NO on the AHCA. The Freedom Caucus, a very conservative branch of the Republican Party, believed that this new bill did not go far enough, and was basically “Obamacare lite.” Those in support of the bill mainly assumed it could be revised later, supporting Paul Ryan’s ‘three bucket’ plan of this being only the first of three bills intended to improve healthcare. The content of the next two buckets was entirely unknown. The vote was pushed to Friday to allow for last-minute bargaining with the Freedom Caucus, but every step towards their position, which included the removal of essential health benefits aka the minimum standard for insurance plans, pushed away more and more moderate Republicans.
Withdrawal
The bill was withdrawn Friday afternoon when it became clear that Ryan’s bill did not have the votes. Only 22 Republicans needed to vote NO to block this bill, and 30-40 had voiced their opposition. Instead of putting it to a vote, the AHCA was withdrawn completely.
What Comes Next?
Paul Ryan and Republicans initially stated their intention to set aside health care for now and allow the ACA to stand, instead focusing on tax reform. Yet this Tuesday, Republicans reaffirmed their intent to repeal and replace the ACA by quietly meeting with different Republican factions and the president’s chief strategist Steve Bannon. It remains unclear as to what will be improved with a new bill, but getting the votes to pass a bill may be difficult with a party divided on health care, despite their control of the House, Senate, and White House.
Follow HCND on Twitter, like us on Facebook, Pin with us and show our Instagram some love!