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The American Health Care Act – Where Do We Go From Here?

It’s been a frantic few weeks. The advance of the American Health Care Act (AHCA) to the House Rules Committee, the remaining step before a floor vote, proves to be one of the longest steps on the timeline. The role of the House Rules Committee is to finalize the “rules” of engagement, i.e. how and when the bill will come to the floor for a vote, the time and limitation of debate, and whether they may introduce other amendments.

On Wednesday, March 22, the Rules Committee did not finish its work before the end of the day Wednesday or Thursday (March 23) resulting in a scramble to finalize. Typically, there is a one-day delay from Rules approval to the actual floor vote, but the introduction and passage of a special “same day rule” sets the stage for both the Rules approval and floor vote Thursday, March 23.

The President’s eleventh-hour meetings with the House Freedom Caucus and Moderate Tuesday, both groups looking for concessions to the bill, result in a few modifications to the bill, namely, the removal of the ACA mandate that all individual and small group health plans contain the ACA-defined essential health benefits.

In light of the fact that the House has chosen not to vote on the budget reconciliation bill to repeal and replace the ACA, the question is – where do we go from here?

Although the House pulled the bill after failing to find enough votes to pass it, the fact of the matter is that action is needed to stabilize the market and make modifications necessary to deliver sustainable programs to the American people.

The cost of medical goods and services is still high, individuals face exorbitant out-of-pocket costs, and more people than ever will suffer ill effects of a declining environment. If this bill moves forward and becomes law, the journey begins. If not, the journey will need to start in a different way. Whichever path, we will continue our pursuit toward better outcomes and quality of care.

Here are the possible next steps, and as always we’ll be sure to keep you updated as events unfold on our ACA Watch page:

  • Modify H.R. 1628 or draft new reconciliation bill to include the provisions that everyone can agree on and once it passes, institute the other regulatory changes and legislative actions to finish out the new plan
  • Abandon the budget reconciliation bill and rely on one of the other eight House repeal bills and work to pass through regular order requiring 51 votes in the Senate
  • Make the decision to dismantle and replace ACA one provision at a time through the regular order passage of bills through the legislature
  • Adopt regulatory changes to alleviate the parts of the ACA that are most onerous or are not in line with the new plan