Just when we thought we knew what the hot topics were for this week, they were blown out of the water as the U.S. House of Representatives passed a bill – by four votes – aimed at repealing and replacing the Affordable Care Act. No one knows if it will stick because now it must be passed by the Senate where uncertainty and a desire to completely rewrite the bill reign.
When news of the bill’s passage broke we saw what looked like glee from the House and an air of defiance from the Senate.
The Atlantic reported: “The American Health Care Act scraps the Obamacare mandates that people buy health insurance and that employers provide it, eliminates most of its tax increases, cuts nearly $900 billion from Medicaid while curtailing the program’s expansion, and allows states to seek a waiver exempting them from the current law’s crucial prohibition against insurers charging higher premiums to people with pre-existing conditions.”
The New York Times reported: “As House Republicans on Thursday shoved their health care bill across the finish line, stuffing it with amendments and extra dollars to secure a hard-won majority, the lawmakers who will inherit the legislation delivered their own message from across the Capitol: That’s cute.
“On the Senate side, where several Republicans have long been deeply skeptical of the House effort, the bill is expected to undergo sweeping changes that might leave it unrecognizable — perhaps stripping away some of the provisions that helped earn the support of hard-right House members and ultimately secure its passage.”
Visceral reaction from healthcare associations
It was just a matter of minutes before health care experts stood up and called the bill “shameful” and “harmful”. Here are a few of their comments:
- The American Medical Association: “People with pre-existing health conditions “face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question.”
- The AARP called the bill “deeply flawed”, saying the legislation would put an “Age Tax on us as we age, harming millions of American families with health insurance, forcing many to lose coverage or pay thousands of dollars more for health care.”
- The American Cancer Society expressed concerns that the bill will leave cancer patients unable to pay for plans, arguing that the bill would make pre-existing condition protections “virtually meaningless.”
The prospect of millions of uninsured Americans
When the Congressional Budget Office looked at the first repeal bill, it estimated that 24 million Americans would lose their coverage. This one was voted on without an assessment from the Congressional Budget Office. However, one can only assume that if Medicaid is cut and the expansion curtailed, millions of Americans will lose their healthcare coverage. The potential financial impact of that on hospitals, healthcare systems, community health centers and physician practices hasn’t been tallied but it’s a safe bet that very tough days lie ahead.
Patient access and value based care are the stated priorities of healthcare executives for 2017. We will wait, watch and see what impact this news has on their ability to stay the course and achieve those goals.
We know that the news on this issue will change faster than the clock in the hours, days and weeks ahead. Details will be unveiled and analysis will churn. What will happen in the senate is anyone’s guess. The only constant seems to be upheaval and the healthcare industry is going to have to batten down the hatches to survive. Toto, we’re not in Kansas anymore.