Obamacare is the Law of the Land…For Now

On Friday, March 24, the American Health Care Act (AHCA) was removed from the House floor resulting in a failure to vote. Although Republicans have voted to repeal the Affordable Care Act (ACA) more than 60 times, this was the first time they presented a detailed proposal to replace the ACA. With control of both the White House and Congress, this was their chance to finally repeal the ACA, but the AHCA wasn’t able to satisfy all of the factions of Republicans and therefore never went to a vote. House Speaker Paul Ryan admitted defeat, stating that:

“Obamacare is the law of the land…We’re going to be living with Obamacare for the foreseeable future.”

However, Speaker Ryan has recently promised to keep pushing to overhaul the ACA, and HHS Secretary Price has refused to commit to implementing the current law. We can expect these efforts to continue.

Washington Responses

Failure of the AHCA is a positive development, particularly for Washingtonians. As demonstrated in this Robert Wood Johnson Foundation and Urban Institute report, Washington would have lost far more federal funding as a proportion of our budget than most states if the ACA were replaced by the AHCA, with its Medicaid per capita caps and decreased federal funding.

Congresswoman Jaime Herrera Beutler was the one Washington Republican who came out against the latest version of the AHCA. She specifically recognized the importance of the Medicaid program as it affects children, and the threat that AHCA presented to this program: “Protecting vulnerable children is a core purpose of the Medicaid program and when the program fails to do so, it fails entirely.” No other Washington Republicans have indicated how they would vote before the bill was pulled, and some continue to keep their vote to themselves.

Washington leaders have been urging the Trump administration to abandon efforts to repeal the ACA and instead take up a bipartisan approach to improve health care for all Americans.

• Insurance Commissioner Mike Kreidler issued a statement.
• Senators Patty Murray and Maria Cantwell, along with 44 other Senators, sent a letter to President Trump.
• Governor Jay Inslee issued a statement.

Our Take on the ACA Repeal

The setback in the Republican effort to repeal the ACA and cut Medicaid funding is a huge victory for health advocates. However, the fight is not over. We anticipate that there will be more threats to these programs that we will need to combat. Here is a good analysis from Community Catalyst of why the AHCA failed, and the need to be prepared and build unity around the need for a just health care system.

While the next moves in Congress are not yet clear, we still expect that there will be more attempts to repeal the Affordable Care Act and end Medicaid as we know it. In addition, at the administrative level, there are quite a few ways in which the federal Department of Health and Human Services (HHS) can make changes without going through Congress. HHS can amend the Obama administration rules governing the ACA and can issue new sub-regulatory guidance, which it has already begun doing. For example, a recent HHS letter to governors urged them to alter their Medicaid programs to allow for work requirements, cost sharing for emergency room visits and premium charges. We will be keeping an eye on the administration’s activities and letting you know when there are opportunities for you to make your voice heard.