Recent reports in the media suggest that the initial momentum for repealing the ACA may be slowing, and members of Congress throughout the country are hearing from constituents expressing a high level of concern about the potential consequences. Recent polling indicates that the popularity of the ACA is growing. In the face of these showings of support for the ACA, congressional Republicans appear to be shifting their strategy by:
- Delaying the date for presentation of a repeal bill.
- Holding hearings to showcase the ACA’s failures with the goal of diminishing insurer and consumer participation in the ACA through confusion and uncertainty.
- Changing their message from “repeal and replace” to “repair.”
Although the strategy is changing, the goal is still to repeal the ACA. Support for full repeal remains strong among congressional leadership. However, there does not seem to be unanimity about what to replace it with, or how to handle a myriad of interconnected policy issues under consideration. Meanwhile, Congress is likely to pursue cuts to Medicaid through block grants to states that make them responsible for taking actions like reducing eligibility, benefits, payments. See here and here for more on block grants and a related form of cut, per capita caps.
We recommend this excellent analysis of the current situation by Michael Miller at Community Catalyst, describing the many uncertainties and contingencies in play. (To keep your finger on the pulse, subscribe to Community Catalyst’s Health Policy Hub blog.)