On Friday, House Speaker Paul Ryan (R-Wis.) announced that he would not be pursuing a vote for the American Health Care Act, which would repeal and replace the Affordable Care Act. The AHCA did not have the votes to pass, and Ryan would not risk seeing it shot down in a public forum.
The retraction of the bill followed two days of intense negotiating between proponents of the bill like Paul Ryan, Vice President Mike Pence, and even President Donald Trump. Due to in-fighting amongst Republicans—conservatives felt the bill was too similar to the ACA, and moderates felt that it left too many people without coverage (an estimated 24 million by 2026 according to the Congressional Budget Office)—and complete stonewalling by House Democrats, the bill proved to be too divisive to pass. Despite numerous massive overhauls and rewrites—most of which the House did not get to see—and a complete lack of research about the future impacts of the new additions, no one could seem to agree on the bill.
Beyond that, the AHCA would see the end of certain “Essential Health Benefits” that had previously been guaranteed to be covered by insurance. That included mental health, addiction, maternity care, hospitalization, and pediatric services. In addition, the AHCA would have had a special provision to cut all federal funding to Planned Parenthood because they perform abortions. The fact that abortions are not covered by federal funding was not important.
Planned Parenthood accepts state health insurance programs like Medicaid. A person can go to Planned Parenthood, which offers preventative care, cancer screenings and gynecological services, for any of those services and use their Medicaid. Planned Parenthood sends an invoice of that visit to Medicaid, which then sends a bill to the federal government for reimbursement. Abortion is not included in one of the services that can receive federal funding for reimbursement.
And while this is a defeat for the Republicans who would like to see the Affordable Care Act gone, it is not necessarily a victory for Democrats—although some choose to see it that way. On many levels, keeping the ACA in place is the best option. By simply removing the ACA would leave an estimated 18 million uninsured (whereas implementing the AHCA would leave 24 million uninsured). But there are still problems with the ACA, and resting on laurels does the Democrats no favors.
Because the ACA requires everyone to be insured, insurance companies hiked up premiums to account for the increase. Sub-groups that previously had low insurance costs (single, healthy men with no illnesses for example) have seen price increases. And because there is only a single enrollment period, if you miss that period and remain unenrolled, you face a monetary penalty. Taxes also had to be raised in order to accommodate the ACA.
Beyond that, some businesses have avoided the employer mandate of providing insurance by cutting back hours justenough to not have to provide their employees with insurance. That leads to working almost the exact same amount of hours, but without the benefits of being a “full-time” employee.
Because the AHCA failed does not necessarily mean that the ACA wins. There are still major problems to be addressed in a wide-scoping healthcare plan.
Be happy that the AHCA did not go to a vote, but do not let that placate you into a lack of action. Healthcare is a messy, divisive and complicated issue, and needs to be constantly reworked.
