The American Health Care Act (AHCA) has reached the Senate and passage is far from certain. With the slimmest of margins the GOP can afford only two defections and at the same time will need to present legislation which is ultimately acceptable to their colleagues in the House. But even the core principles such as Medicaid expansion are contentious – there are some members who are convinced that repealing the expansion is the only acceptable solution, while others want to retain it, despite the costs. Senate Leader Mitch McConnell has created a 13-member working group to come up with a compromise and it looks like they may not be starting from the AHCA, but from scratch.
Under Senate rules CBO scoring is required before a bill can be passed, so unlike in the House, the impact on the uninsured will be front and center in this effort. Scoring for AHCA is scheduled for the week of May 22, so expect to hear more about the number of Americans losing coverage – this will be a pain point for Republicans.
On the other side of the aisle, the Democrats are on board with the need to repair the ACA. Their request is for the GOP to drop their demand for repeal. This will be a high stakes gamble for Republicans. If they are not successful in making significant incremental change this will impact the 2018 midterm elections and may lead to another shift in power.
Healthcare has the potential to increase the partisan division or strengthen our political system. Call your Senator; only by consensus will a long-term viable solution arise. When looking at the popular sentiment, everyone wants to get to the best answer. Hopefully our politicians can find that across party lines.