- HHS Secretary Tom Price on Tuesday said the recently released ACA repeal-and-replacement bill – named the American Health Care Act (AHCA) – is a "work in progress," Reuters reported.
- Reactions from all sides of the industry started to pour in and, depending on what color lenses you're viewing reactions with, the initial reaction doesn't look pretty. J. Mario Molina, CEO of the insurer Molina Healthcare was quoted in The Wall Street Journal saying "You’re going to see big rate increases, and you’re going to see insurers exit markets…this is going to destabilize the marketplace."
- Conservative healthcare analyst Avik Roy used the following headline in Forbes for an opinion piece: "House GOP's Obamacare Replacement Will Make Coverage Unaffordable For Millions – Otherwise, It's Great".
The AHCA is getting criticism from all sides and is centered in a big pile of uncertainty regarding varying ACA repeal bills. But when push comes to vote, it will come down to the Republicans to decide whether to go forward with the new repeal-and-replace bill.
So far, the bill hasn't been taken positively from either side of the aisle. Democrats obviously oppose the legislation but several conservatives have taken shots at the measure as well. Heritage Action CEO Michael Needham released a statement on Tuesday saying, "Many Americans seeking health insurance on the individual market will notice no significant difference between the Affordable Care Act (i.e., Obamacare) and the American Health Care Act. That is bad politics and, more importantly, bad policy."
The American Medical Association called the bill "critically flawed."
“The AMA supported health system reform legislation in 2010 because it was a significant improvement on the status quo at the time; and although it was imperfect, we continue to embrace its primary goal – making high-quality, affordable health coverage accessible to all Americans,” AMA President Dr. Andrew Gurman said. “As drafted, the AHCA would result in millions of Americans losing coverage and benefits. By replacing income-based premium subsidies with age-based tax credits, the AHCA will also make coverage more expensive – if not out of reach – for poor and sick Americans. For these reasons, the AMA cannot support the AHCA as it is currently written.”
Former CMS acting administrator Andy Slavitt wrote an opinion piece in The Washington Post stating the most lasting impacts of the measure would be steps toward "forcing permanent changes to Medicaid and Medicare." He added, "If this bill became law, [House Speaker Paul Ryan] would finally be positioned to change Medicare to a voucher program." AARP EVP Nancy Leamond had similiar concerns with Medicare, writing in a statement the organization opposes the AHCA stating it would "would weaken Medicare, leaving the door open to a voucher program that shifts costs and risks to seniors."
The American Hospital Association released a letter on Tuesday stating any ability to evaluate the bill is "severely hampered by the lack of coverage estimates by the Congressional Budget Office...[I]t appears that the effort to restructure the Medicaid program will have the effect of making significant reductions in a program that provides services to our most vulnerable populations, and already pays providers significantly less than the cost of providing care."
Sen. Rand Paul (R-KY) – who was trying track down an earlier draft of the bill last week – tweeted out Tuesday morning:
Th House leadership plan is Obamacare Lite. It will not pass. Conservarives are not going to take it. #FullRepeal— Senator Rand Paul (@RandPaul) March 7, 2017
Later that afternoon, Paul along with other members of the House Freedom Caucus, publicly opposed the AHCA during a press conference where the group announced it would reintroduce the original 2015 reconciliation bill that fully repealed the ACA. The 2015 measure made it to then-President Barack Obama's desk and he quickly vetoed the measure. Many saw the reconciliation bill as more of a symbolic gesture than actual, sustainable policy, but it did fully repeal the ACA, something the members of the House Freedom Caucus want.
Paul admitted that Republicans are divided on ACA replacement but are united on repeal. He called for separate legislation for "repeal" and "replace." The AHCA did not go far enough for repeal in their eyes. Sen. Mike Lee (R-UT) called the legislation a "missed opportunity" and a "step in the wrong direction." The speakers pressed for party members to fully repeal the ACA and to then vote on a course of action for replacement.
In the Senate, the GOP can only afford to lose two votes, assuming no Democrats vote to pass the bill, to move the legislation forward. The House Freedom Caucus members could muddy the certainty to which the bill is passed. Still, with all the potential GOP infighting, the AHCA is the ACA repeal plan coming from party leadership. Regardless of whether Congress members such as Paul and Lee think the measure doesn't go far enough, this could be the party's only shot to dismantle the ACA.
President Donald Trump, who is meeting with conservative leaders about the bill Wednesday, noted in a tweet that the bill is still under negotiation. He later added, though, that he expected detractors to ultimately vote for the bill and wants to see it passed.
To that end, when the time comes to vote on the bill, Republicans may shallow their differences over replacement and hold the party line to make movement on changing the ACA.