On March 6th, House Speaker Paul Ryan unveiled the American Health Care Act, or AHCA, to the house floor. Since 2009, the Affordable Health Care Act or ObamaCare had been in place, and now Ryan proposed a vote on it’s 7th anniversary, March 23rd. President Trump tweeted his support of the bill, calling it “our wonderful new Healthcare Bill” and adding “ObamaCare is a complete and total disaster” in his usual form.
Both moderate and extreme conservatives immediately criticized AHCA, and cast into doubt the solidarity of the ruling party. Notably the Freedom Caucasus, 29 members strong, disliked the similarities to ObamaCare and promised a “no” vote. The current party divisions in the house left 194 democrats and 241 Republicans—for ACHA to pass, only 23 Republican dissents were necessary. The bill needed a simple majority, but all democrats were vocally opposed to the replacement plan.
The bill’s policies kept in place policies such as coverage under parents’ plans until age 26 and clauses that prevented companies denying coverage based on health. In fact, what it did change were laws that determined premiums based on wealth and replaced them with costs determined by user age—essentially, this helped young adults and the rich but harmed older and poorer citizens. AHCA also came with cuts to Medicaid and Medicare programs that help those with disabilities, low income, or who are over 65.
Federal healthcare is reliant on a varied user base in order to balance costs between those who are healthier or in poor conditions. ACHA removed many incentives for healthier people to stay on the plan and as such, costs would probably go up for most users. However, AHCA does include around $337 billion in savings over 10 years, a very significant decrease in costs from previous healthcare bills.
Supporting Republicans coined the bill as “universal access” rather than “universal coverage”—President Trump touted both phrases over the campaign and in the Oval Office. The shift in wording makes a large impact in the legislation, and instead of promising health care for all it gives the impression that people will be able to have more choice. This promise of choice came at a great cost, however; the CBO (Congressional Budgetary Office) as a non-partisan group estimated 24 million additional people would lose insurance over 8 years. To put this into context, 28 million people are currently uninsured, and the bill would nearly double that.
Trump used this opportunity to showcase his negotiating prowess, one of his traits he often cited in the campaign trail. He and Ryan made changes to try and appease more conservative members of the house who were opposed to AHCA by lowering maternal care and deductions. However, by the 23rd the votes were not there, and anywhere from 28 to 30 Republicans were poised to defect, and polling in the public showed abysmal support of around 17%. After a similar battle on the 24th, the date to which Republicans moved back the vote, Trump conceded and pulled the bill, though not before blaming Democrats, saying they “own[ed] ObamaCare.”
TThe defeat of AHCA is a Democrat victory, though it may be short lived. Republican interparty problems are what destroyed the bill, and their reasons for dissent are the polar opposite of Democrat opposition. On the other hand, President Trump gave an ultimatum and ultimately failed to pass a bill and repeal ObamaCare. Not only this, but his agenda is now derailed and he has lost an initiative on health care. Republicans will try and lick their wounds, but if they cannot pass legislation even with a friendly president and majority in Congress, the next 4 years are going to be disappointing for their voters.
“Donald Trump’s US Healthcare Bill Withdrawn.” BBC News, BBC, 24 Mar. 2017, www.bbc.com/news/world-us-canada-39387550.
Glenza, Jessica, and Lauren Gambino. “Republican Healthcare Plan: 24 Million People Could Lose Coverage, CBO Reports.” The Guardian, Guardian News and Media, 13 Mar. 2017, www.theguardian.com/us- news/2017/mar/13/budget-office-republican-healthcare-coverage-deficit- costs.