Despite previously pulling the American Health Care Act from the U.S. House floor, chamber lawmakers voted Thursday to advance a revised version of a Republican plan to dismantle the Affordable Care Act.
Despite previously pulling the American Health Care Act from the U.S. House floor, chamber lawmakers voted Thursday to advance a revised version of a Republican plan to dismantle the Affordable Care Act.
The new AHCA, which some have called "Trumpcare," looks to undo much of President Barack Obama's signature health care law through refundable tax credits, overhauls to Medicaid and an expansion of health savings accounts, among other things.
The measure, which narrowly passed the House on a 217 to 213 margin just over a month after Speaker Paul Ryan, R-Wisconsin, canceled the initial vote due to lagging support, now moves onto the Senate.
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In an effort to revive the AHCA after its initial failure to gain traction among Republicans, lawmakers amended the bill to allow states to apply for waivers from the federal government to cancel some ACA regulations that would reduce residents' costs -- a move which some critics say could result in people with pre-existing conditions being charged more for insurance.
Lawmakers also added a provision to the bill that would allocate an additional $8 billion over five years for states seeking a waiver and add a reported $15 billion for a federal risk sharing program.
U.S. Rep. Fred Upton, R-Michigan, who introduced the $8 billion amendment, said it was designed to help lower costs for those with pre-existing conditions, but the measure does not specify that the funds be used for those individuals, according to reports.
Ryan, however, stressed that "the law is clear: Under no circumstance can people be denied coverage because of a pre-existing condition." The two amendments added to the AHCA, he added, offer "two more layers of security for these individuals."
Contending that the current health care system under so-called "Obamacare" is collapsing, Ryan said the bill delivers on the promises lawmakers made to the American people.
"A lot of us have been waiting seven years to cast that vote. Many of us are here because we pledged to cast this very vote: to repeal and replace Obamacare, to rescue people from this collapsing law...we will not falter, we will replace and today is the day we are going to do this," he said.
According to the speaker's office, the GOP-backed bill looks to "equalize the tax treatment of health care" through refundable tax credits, give states new control over Medicaid, nearly double the amount Americans can contribute to health savings accounts and defund Planned Parenthood.
U.S. Rep. Richard Neal, D-Springfield, however, raised concerns about the legislation's impact on individuals with pre-existing conditions.
"That child who is born with diabetes across America can no longer be guaranteed health insurance if we turn this option over to the states," he said in a speech from the chamber floor. "Anybody who's come from local or state government, you know this: that money will be used to balance the budget in economic downturns at the expense of those who need it for health care."
The top Democrat on the House Ways and Means Committee further took issue with the process through which the measure was brought up for a vote, arguing that it had "all the charm of a ransom note."
"The idea that this is put in front of us so that they could provide a tax cut at the expense of middle-class Americans is really what we're voting on today," he said.
Congressman Jim McGovern, D-Worcester, also accused the GOP plan of taking away protections for pre-existing conditions and pointed to various health care advocacy groups who have come out against the AHCA.
"If the American people could sue Congress for malpractice, my Republican friends would be in deep trouble...you are taking away essential health care protections, you're allowing insurance companies to discriminate against people with pre-existing conditions, you're supporting a bill that will throw 24 million people off of their health care and cut Medicaid by $880 billion to give a $1 trillion tax break to the wealthiest people in this country," he said in a floor speech. "What is wrong with you guys?"
Massachusetts Gov. Charlie Baker, a Republican who spoke out against the original AHCA proposal, said although the bill has been amended "it would still result in a massive loss of critical funds for the Commonwealth."
"I am thankful for the federal government's willingness to work with Massachusetts to deliver greater flexibility through the Medicaid system and I hope Congress reconsiders this amended legislation," he said adding that his administration "will continue to protect Massachusetts' health care system, which leads the nation in health care coverage."
Massachusetts Democratic Party Chair Gus Bickford, however, said Baker should have called on Ryan "to withdraw the bill until a full analysis of its effects can be completed, and then begin lobbying the members of his party and speaking out publicly against this cruel bill."
Prior to voting on the AHCA, lawmakers overwhelmingly approved legislation removing an exemption for Congress and their staff from changes included in the GOP health care plan.
Ryan lauded the vote, saying "Congress should live by the same rules it creates."
Congress should live by the same rules it creates. House just voted to ensure no member will be exempt from the American Health Care Act.
-- Paul Ryan (@SpeakerRyan) May 4, 2017