The following are some of the most important changes the Senate GOP should make to the House bill:
Strike a Medicaid Compromise.
Provide More Generous Subsidization of Lower-Income Households.
Fix the AHCA’s Premium Surcharge.
Limit the Tax Preference for Employer-Paid Premiums.
Provide More Flexible Use of HSAs.
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Almost every promise made eight years ago about ObamaCare turned out to be a falsehood. You couldn’t keep your insurance plan, doctor or provider in many cases. It didn’t save $2,500 per family (more like $2,500 more). It didn’t lead to expanded patient choice. And the tax increases badly hurt the economy and jobs market, and the insurance markets really have entered a death spiral that if left unfixed will blow-up the entire insurance market.
The fundamental lie of ObamaCare is revealed in the law’s very title: The Affordable Care Act.
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Our ongoing troubles with health care stem from an unwillingness to deal with certain facts. One of those facts is scarcity. “Scarcity” is a term from economics, and it refers to the fact that there is never enough of anything to satisfy every possible desire — the universe holds only so much, and human desire has a way of outgrowing whatever we have. So we have to come up with a way of dividing up that which is scarce. We have tried many different ways of doing that — war, caste systems, central planning — though mostly we’ve relied on the fact that everybody wants lots of different things, which makes it possible to trade. But buying and selling stuff is not, to be sure, the only way to divide up that which is scarce.
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We pride ourselves on being a compassionate society, and insurance companies use this to manipulate us into sharing the costs of other people’s excessive health care. Meanwhile, 5 percent of Americans generate more than 50 percent of health care expenses. Why shouldn’t a patient who continues to see me unnecessarily pay more?
The government’s job is to maintain public health and safety. It should ensure that insurance plans include mandatory benefits like emergency, epidemic, vaccine and addiction coverage. The Republican bill would let states apply for waivers to define these benefits differently; it would be a big mistake to drop such coverage entirely.
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When you’re facing years of doctor’s appointments, you want to know that having a preexisting condition, such as an extra 21st chromosome or a heart defect, won’t prevent you or your loved ones from accessing the care you need. And despite what people are saying, House Republicans aren’t seeking to strip these protections—or anyone’s protections—away. Our effort to create a better health-care future for all Americans isn’t finished. Whether it’s allowing insurance to be purchased across state lines or implementing other insurance reforms, we will continue our work until every American has access to good-quality, affordable health care and our most vulnerable communities have peace of mind.
AHCA contains many important reforms, but it risks throwing millions of low-income Americans off of their health insurance plans. Senate Republicans can fix this—but only if they prioritize sound health care policy over short-term messaging. Improvements to the health care system need to do four things: (1) establish a functioning individual health insurance market by replacing Obamacare’s exchanges; (2) gradually raise Medicare’s eligibility age for future retirees so that more people in their sixties would buy individual coverage that is subsidized where needed; (3) gradually migrate certain populations out of Medicaid and into the individual market; (4) address the grab-bag of other health-reform problems like medical malpractice, hospital consolidation, drug pricing, and veterans’ health care.
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Senate Republicans said Thursday they won’t vote on the House-passed bill to repeal and replace Obamacare, but will write their own legislation instead.
A Senate proposal is now being developed by a 12-member working group. It will attempt to incorporate elements of the House bill, senators said, but will not take up the House bill as a starting point and change it through the amendment process.
“The safest thing to say is there will be a Senate bill, but it will look at what the House has done and see how much of that we can incorporate in a product that works for us in reconciliation,” said Sen. Roy Blunt, R-Mo.
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This summary from the Kaiser Family Foundation describes key provisions of H.R. 1628, including: 1. Repeal ACA mandates, standards for health plan actuarial values, and premium and cost sharing subsidies; 2. Modify ACA premium tax credits for 2018-2019; 3. Retain private market rules; 4. Retain health insurance marketplaces, annual Open Enrollment periods, and special enrollment periods; 5. Impose late enrollment penalty for people who don’t stay continuously covered; 6. Establish State Patient and State Stability Fund with federal funding of $130 billion over 9 years, and additional funding of $8 billion over 5 years for states that elect community rating waivers; 7. Encourage use of Health Savings Accounts; 8. Convert federal Medicaid funding to a per capita allotment.
Republicans finally hit a home run with a 217-213 vote Thursday to pass a health care bill that will help millions of struggling Americans. They proved they can govern. Yet one of Republicans’ most notable successes is so far getting too little recognition. GOP negotiators embraced the only model that can ultimately see this bill successfully to President Trump’s desk: states’ rights. The compromise is far from perfect—concocted, as it was, under pressure, and with dozens of competing interests in the room. The Senate offers Republicans an opportunity to do much better by building on the idea’s model of states’ rights.
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In a major victory for President Donald Trump, the House has voted to dismantle the pillars of the Affordable Care Act and make sweeping changes to the nation’s health care system.