With President Trump’s 100th day in office upon us, major Republican leaders, including Reince Priebus, Trump’s Chief of Staff, were eager to once again put their re-worked health care bill to vote earlier this week. The repeal and replacement of the Affordable Care Act enacted by former President Obama, was one of the major campaign promises during President Trump’s campaign before the completion of his one hundred days in office. By Thursday evening, however, it was evident that the bill still did not have enough support and it was announced that it would not reach the floor for a vote.
The Trump administration suffered a major defeat late last March when Speaker of the House, Paul Ryan, decided to pull their health care bill from the floor after realizing that it would not receive enough votes to pass. Since then, a re-worked bill has emerged and includes familiar provisions such as replacing the income-based tax credit with an age-based credit, cutting back on Medicaid, and repealing most Obamacare taxes.
Although the bill has been updated many times since it was pulled off the senate floor in late March, it still did not gain enough support amongst the Republican Party. The associated press reported that more than a dozen Republicans, mostly moderates, said they were opposing the legislation. Many others remained publicly uncommitted, putting party elders in a tough spot. If 22 Republicans defect, the bill would fail, assuming all Democrats opposed it.
Republicans saw a glimmer of hope in receiving the needed votes when Congressman Tom MacArthur drafted a recent amendment which would allow states to seek waivers in certain provisions of the bill and was supported by the conservatives in the House Freedom Caucus. A run-down of the revised bill by Michael Chernew, a professor of Health Care Policy at Harvard Medical School, points out that these provisions include rules surrounding essential benefits that all insurers are required to cover such as hospitalization, maternity and newborn care, mental health, prescription drugs, preventive care, pediatric care, rehabilitation, and many others. This could leave states with widely varying rules on these services if they seek and are granted the waivers.
Even after the amendment, however, the bill did not gain enough support for a final push in putting it to vote with Republican Party Members, such as Ryan Costello, issuing the following statement:
“Protections for those with pre-existing conditions without contingency and affordable access to coverage for every American remain my priorities for advancing healthcare reform, and this bill does not satisfy those benchmarks for me. I do believe substantial reforms need to be made to our healthcare system. I will review any future modifications or legislation with these principles in mind, but I remain a no vote on this bill in its current form.”
By the sound of it, Speaker of the House, Paul Ryan, will wait until the time is right to put the bill on the floor, stating, “We’re going to go when we have the votes.” With as rocky as the passing of this health care bill has been, it's hard to predict if and when any new legislative updates will take place.
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