Dive Brief:
- Republican Senate aides are said to be drafting the upper chamber’s version of the American Health Care Act (AHCA) to replace the Affordable Care Act (ACA) this week while Congress is on break. There is no indication, however, that much progress is being made on sticking points such as Medicaid funding and coverage for people with pre-existing conditions.
- Medical groups, which have railed against many of the Republican healthcare ideas, are split on whether to exclusively campaign against the bill or attempt to work with Republicans to make it more palatable, according to The Wall Street Journal.
- Meanwhile, insurers continue to announce significant rate increases if the cost-sharing reduction (CSR) payments are not made. Some CEOs have outright blamed President Donald Trump’s administration for dragging its feet on any decision regards CSRs.
Dive Insight:
The AHCA has never been a popular bill outside of those who crafted it, but sentiment from industry leaders, other legislators and voters is getting demonstrably worse.
In their home states Senators continue to face angry crowds at town halls. They’re upset about the Congressional Budget Office’s analysis of the most recent version of the AHCA, which found it would leave 23 million uninsured and result in skimpy coverage for the poor and elderly.
In an opinion piece published Tuesday in U.S. News and World Report, recently ousted Molina CEO Mario Molina said Republicans are peddling a false narrative when they say the ACA exchanges are in a death spiral and cannot recover.
"In fact, most of the instability driving up premiums in the marketplace can be directly traced to Republicans' efforts to undermine the healthcare law for their own political purposes," he wrote.
Polls are showing less and less support for the AHCA among voters as well. A recent survey found that more than half of people viewed the bill negatively and only 8% want it passed as is. Even the administration is distancing itself from the House version, which CMS Administrator Seema Verma recently called “outdated.”
Trump has baffled the healthcare industry with recent tweets about the AHCA.
I suggest that we add more dollars to Healthcare and make it the best anywhere. ObamaCare is dead - the Republicans will do much better!
— Donald J. Trump (@realDonaldTrump) May 28, 2017
It’s unclear what he meant but the AHCA currently makes large cuts to the NIH, CDC and healthcare programs like Medicaid. He wrote more later.
The U.S. Senate should switch to 51 votes, immediately, and get Healthcare and TAX CUTS approved, fast and easy. Dems would do it, no doubt!
— Donald J. Trump (@realDonaldTrump) May 30, 2017
But the budget reconciliation process Republicans intend to use to pass the bill already requires only 51 votes.
Republicans are running out of time to get the AHCA through the Senate. They face a deadline for using the budget reconciliation process — the only realistic way the bill could get approved — at the end of September. And Congress still needs to reach a deal on raising the debt limit, which has historically held up legislation.
There could be progress on the legislation as Congress returns next week, but there doesn't seem to be clear path forward as of yet.