Healthcare in the Trump Era Takes Its First Step

Today, the House narrowly passed the American Health Care Act; the Republican answer to Obamacare. In order to garner support from reluctant House members there were several important changes from the bill that failed to pass two months ago. The first change would allow states to opt out of exchange requirements and give the states the power to allow insurers to charge higher premiums for people with pre-existing health conditions should they let their coverage lapse. The bill also establishes a high-risk claim pool to reimburse insurers who get hit with high-cost claimants.

Unlike the first Trump-led repeal effort, this bill passed prior to scoring by the Congressional Budget Office (CBO). Many felt that it was the CBO scoring, which estimated up to 24 million Americans would lose coverage, that blocked passage at the time.

The House vote is just a milepost along the way to a possible repeal of the Affordable Care Act. The next stop is the Senate where Republicans hold a two-vote majority. No doubt, the party infighting in the House will be equally painful in the Senate and it is unlikely that the Senate will pass the bill as it is presented. More likely, if they are able to reach compromise, it will be with a Senate version of the bill. The House and Senate versions would be reconciled and voted on and then need to go through another difficult round of votes.

This bill will be a steep uphill climb and there is a lot at stake for the GOP who, at this point, holds all the cards. President Trump has been very clear in his messaging and he seems to be pretty persistent. My gut feeling is that a more watered-down version of the AHCA will ultimately get to President Trump for signature. But hold on – the road will be bumpy.

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