House passes health care bill; Senate says it will write its own
The U.S. House of Representatives started the long process of Obamacare repeal and replacement when it recently passed the American Health Care Act (AHCA) by a slim margin of 217 to 213. The billês passage came a month and a half after the first attempt failed to attract the votes of both moderate Republicans and the conservative Freedom Caucus. Some Republicans said the bill that passed is imperfect, but they were anxious to get something passed.
The ins-and-outs of negotiation were widely reported in the media, from comedian Jimmy Kimmelês tearful plea for his ill infant son to Fred Uptonês (R-MI) refusal to support a bill unless it provided insureds with freedom from pre-existing conditions. An amendment spearheaded by Rep. Upton adds $8 billion over five years to pay for those with pre-existing conditions. The final bill was passed after three hours of debate, without an analysis from the Congressional Budget Office of the billês cost or its effect on how many people would lose or gain insurance. The earlier bill lost support from some members of Congress when the CBO said it would cause 24 million people to lose coverage.
The ACHA allows states to apply for waivers to opt out of certain requirements of the Affordable Care Act, a.k.a. Obamacare. It also allows states to apply for a waiver that would permit insurers charge five times as much for older people as it does for younger ones, up from three times as much under Obamacare.
The bill reflects Trumpês philosophy that states, rather than the federal government, should make their own policy decisions. That could cause confusion for insurers that do business in several states. Maryland and DC, for instance, would likely make different decisions from Virginia.
The next move is up to the U.S. Senate, where the signal has been that the upper body will write its own bill, not work with the House version. Some observers believe that negotiators from both chambers will work on a new compromise bill. Whatever happens, the process is far from over.Download Bulletin PDF