Published: Tue, May 09, 2017
U.S. | By Eddie Scott

A closer look at the House GOP's health care bill

The fight to repeal and replace the Affordable Care Act is just getting started.

And influential members of the Senate are already saying their version could look significantly different than the House version.

Sen. Susan Collins of ME, a moderate Republican whose vote will be critical to getting a bill to Trump's desk and who voiced similar concerns, said the Senate would not take up the House bill. It offers states the opportunity to opt out of the Affordable Care Act's rigid regulatory regime and includes a significant amount of funding (up to $123 billion over 10 years) to build mechanisms at the state and federal levels to ensure those with pre-existing conditions get access to affordable coverage. A number of Republican senators have indicated that they want to see the bill overhauled, but Galen Institute President Grace-Marie Turner says the House did most of the Senate's work for it.

"I've already made clear that I don't support the House bill as now constructed", said Sen. The White House has said he'll sign the bill.

The Washington Post reported disagreement among Senate Republicans on how to even begin the process of drafting their bill.

Several Republican representatives have said they did not read the bill, instead relying on staff or the media to understand its potential effects.

The 217-213 vote was a narrow victory, and ultimate success is far from assured since the measure must still make its way through a highly skeptical Senate. Senate leaders have repeatedly vowed success.

"Make no mistake, this is a repeal and a replace of Obamacare, make no mistake about it", Trump declared.

Additionally, if people seek out plans that do provide for mental health or substance abuse treatment, they could face higher premiums for these now-specialized plans.

Republicans have long contended that the law is an unprecedented overreach of federal authority.

Doug Walter, associate executive director of government relations at the American Psychological Association, fears that curbing funding for Medicaid expansion in 2020 means many will lose a key "safety net".

Many state GOP governors and attorneys general also balked at the law's mandated Medicaid expansion, resulting in lawsuits that eventually led to a U.S. Supreme Court ruling making Medicaid expansion optional. Under the Republican proposal, states could get exemptions from those rules by requesting a federal wavier.

It is hard to tell how many people could pay more if the Republican bill becomes law. Some don't like its easing of Obama coverage requirements on insurers, and others think its tax credits must be redirected toward lower-income people.

Cruz said House conservatives won "a positive improvement" with provisions letting states get federal waivers so insurers can charge some people with pre-existing conditions higher premiums, and letting states decide which medical services insurers must cover. Democrats are also refusing to participate in any effort to dismantle Obama's law, while some Republican senators " Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Cory Gardner of Colorado and Lisa Murkowski of Alaska " object to cutting Medicaid, the federal-state health care program for the poor and disabled.

"And they have to provide a structure of subsidies going forward for people to be able to afford health insurance who are at the lower end of the income scale or who just can't afford the full cost of the premiums", she said. These subsidies help reduce copays and deductibles for certain low-income Obamacare customers. Almost every community in America would be afflicted by this loss.

Republicans say the Affordable Care Act is unsustainable. And for a while, in the 1980s, it was apparently not unheard of for health insurance companies to deny coverage to domestic abuse victims.

"Congress' success in producing this bill shows that when we come together and work through our differences we can do the work of the American people". "In its current form, the (American Health Care Act) would roll back major provisions in the Affordable Care Act, jeopardizing the health care of 350,000 Oregonians, increasing prices for elderly Oregonians, reducing federal funding for Medicaid enrollment, and risking the loss of more than 23,000 jobs that were created in OR after the implementation of the ACA".

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