The moment the Affordable Care Act (ACA) was passed as law, the Republican party has fought to find a way to repeal it. With a Republican president and a Republican controlled house, they now stand the best opportunity for health care reform. And that is precisely what President Trump has vowed to do.
Repeal and replace are the focus of the Republicans, but even so their first attempt has already failed to capture the votes needed to get it passed. Even before it could be voted on, Republican leadership removed the bill due to a lack of support. The question is, where does the American Healthcare Act (AHCA) go from here? Why did the most recent repeal attempt fail to go through? What will trumpcare look like in the coming years of his administration?
Understanding Recent Repeal Attempts
The recent reform hurdle Republicans faced was far from child’s play. The Republicans attempted to form a bill that would focus primarily on reforming the ACA, but didn’t garner the support they needed to be successful. Much of this was due to the divided plight of the party itself. Moderates didn’t want to see an end to the Essential Benefits and tea partiers weren’t willing to settle for anything less than complete free market control. For most of the latter, the belief is that government involvement drives up costs of healthcare, not the market itself.
The failure to unite the party on fundamentals of the repeal was its downfall. Key provisions such as preexisting conditions, minimum essential benefits, and the ability for young people to stay on their parent’s healthcare plans until the age of 26, are favorites of the ACA and are difficult to repeal.
The primary focus of the AHCA, however, was the elimination of as much of the ACA’s taxes as possible. The health care reform was loaded with taxes and penalties for both individuals and employers who didn’t offer coverage. The employer mandate came with a tax of 4 percent over the price of insurance for employers who opted for private insurance over the exchange. Individual’s face a similar penalty for refusal to opt in to the healthcare exchange.
It is now past the point of no return for the AHCA. The bill failed to produce results. Because of this, republicans are now forced to take a harder look at where they are willing to compromise and provide real reform to the healthcare industry.
Trump Care—Where the President Stands on Healthcare Reform
After the bill went dead, President Trump publicly said that healthcare reform is at a standstill for the foreseeable future. However, there are still house republicans who wish to see more urgency in repealing the ACA.
Trump’s strict negotiating tactics have given the Republicans little choice but to follow suit or have the law remain as it stands. They now have to answer to constituents who are concerned about losing coverage.
Interestingly, house Republicans are considering reigniting trumpcare. After making a few slight changes to the bill, such as adding a $15 billion risk-sharing fund to help fund health insurers with high-cost patients, Trump has made it apparent he wants results on the healthcare bill. Speaker of the House, Paul Ryan, has said that he would happily bring members back to vote on the bill if a path towards 216 appeared. The issue trumpcare faces now is the Freedom Caucus.
What’s Next for Healthcare Under Trump’s Administration?
We aren’t a full six months into President Trump’s presidency, so it’s safe to assume that new amendments to the bill will come forward and we could very well still see health care reform within the next four years. For now, however, employers and individuals do well to adhere to the ACA as the individual mandate and employer mandate is still in effect.
While Republicans try to repeal the ACA for good, we can’t expect much in the way of changes to minimum essential benefits or other similar provisions. The penalties could be under fire, however, which many small business owners wouldn’t argue against. Still, it will take time to get a complete bill on the floor that can be supported by both sides of the aisle. Until then, Republicans are likely to turn their attention to tax reform, which could present even greater challenges.
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