AHCA passes the House: Republicans take the first step in ACA repeal and replace

Today, House Republicans took the first significant step toward repealing and replacing the Affordable Care Act (ACA) by narrowly passing the American Health Care Act (AHCA) with a 217 to 213 vote. The road to the bill’s passing was not an easy one. The party stood divided for months over key issues such as Medicaid funding, ACA mandates, and pre-existing conditions, which prevented them from making any real progress. And these differing views resulted in the original replacement plan failing to reach a vote at the end of March.

With last night’s release of an amendment allowing states to opt out of key ACA provisions, including underwriting parity and the commitment of an $8 billion dollar fund to support high-risk pools for individuals with pre-existing conditions, Republicans managed to gain enough support to pass the bill today.

Many Republicans are already touting this as a victory to fulfill their promise of carrying out a mandate to repeal and replace the ACA for their constituents. While this is certainly progress, there’s still a very long way to go before the AHCA becomes the law of the land. The bill now moves to the Senate, but many conservative Republicans fear drastic changes will be made to key points of the bill they supported.

The bill also has yet to receive a score from the Congressional Budget Office (CBO), a significant fact that should not be overlooked. It is highly likely that a CBO score of the bill and its amendments would indicate even higher premium increases in the short and long term, especially for those with pre-existing conditions.  Many organizations, including the American Medical Association (AMA) and AARP, have reinforced that removing parity for underwriting rules that were conceived under the ACA will result in skyrocketing premiums for individuals with pre-existing conditions and for the elderly. Previous CBO scores presented issues for Republicans as they faced harsh public backlash over the projected results.

Once a new CBO score is conducted, many Americans may view it as a step backwards rather than an improvement on the current situation. Republicans will soon face public response as they head off to town hall events during the congressional recess. For now, we’ll be watching how all of these things will play a major role in the journey forward for the AHCA. The one thing we can say for certain is that nothing will happen quickly.