The House bill eliminates the Affordable Care Act requirement that insurers cover certain essential services. Many of these services, like mammograms, birth control, and prenatal and maternity care, are used primarily by women. Women are more likely than men to use mental health care and prescription drugs, both of which are considered essential under the Affordable Care Act. If the requirement is scrapped, plans could choose not to offer such services. Plans that offer maternity care could become prohibitively expensive.
.. By cutting $880 million from Medicaid over 10 years, the House bill removes a crucial source of coverage for many women’s health services. Almost half of all births in the country, and 75 percent of publicly funded family planning services, are covered by Medicaid. Slashing Medicaid funds would be especially harmful to black and Latina women, who are more likely than white women to be insured through Medicaid.
.. The bill allows states to waive the requirement that insurers cover people with pre-existing conditions without charging higher premiums.
.. many of the conditions that prompted insurers to deny coverage or raise premiums before the requirement was in place, including depression, lupus and multiple sclerosis, are more common in women. Some insurers also denied coverage or charged higher premiums to women who had given birth by C-section.
.. Mitch McConnell, initially convened a health care working group composed of 13 men and no women. Following widespread criticism, the group invited Senator Shelley Moore Capito, Republican of West Virginia, to a meeting, but it is unclear whether she will become a regular member.
s Health care is now set to be a defining issue in the next election cycles
Governors, gubernatorial candidates and state legislators, meanwhile, will be asked whether they intend to “opt out” of provisions in the Affordable Care Act that are overwhelmingly popular with voters, as is permitted under the Republican plan. Their plans for state Medicaid programs also will be scrutinized if massive GOP cuts to Medicaid funding are realized.
.. I can’t recall a vote this significant in terms of its political potential in 20 years.”
.. Trump’s political advisers calculated that it was less damaging electorally for congressional Republicans to pass a bill that some of their constituents see as deeply flawed than to have passed nothing at all.
.. Polling shows that the public disagrees with Republican health-care plans. Thirty-seven percent of Americans support repealing and replacing the law known as Obamacare, while 61 percent want to keep it and try to improve it
.. slash Medicaid spending by more than $800 billion and cut nearly $600 billion in taxes under the health-care law, most of which will benefit the wealthiest Americans.
.. the Republican bill would lift that prohibition and give states the option to let insurers charge more for them.
.. Wilson added, “Republicans in the House right now should be on their knees praying for the Senate to kill this,” arguing that the line of attack would be less powerful if the bill does not become law.
.. whether it’s the AARP saying it charges people over 50 five times more, or the American Cancer Society saying it guts protections for preexisting conditions. There’s no real way to defend that to voters.”
Trump’s Renewed Focus on Health Bill Vexes GOP Tax Overhaul Strategy
Mr. Trump signaled last week that one of the reasons he has reprioritized health care is that he was relying on savings from the health bill to bolster the tax plan.
.. If the health plan is signed, “we get hundreds of millions of dollars in savings that goes into the taxes,”
- .. an additional 3.8% tax on high-income households’ investment income,
- an extra 0.9% tax on top earners’ wages and
- various taxes related to health-care, such as medical devices.
.. repealing those taxes and offsetting the effect on budget deficits by cutting Medicaid, the health program for the poor.
.. lower projected federal revenue by about $1 trillion over a decade.
.. Republicans on Capitol Hill worry that they may not be able to adopt a 2018 budget resolution because of intraparty disagreements on spending.
Paul Ryan Failed Because His Bill Was a Dumpster Fire
It was bad policy, not poor tactics or negotiating skills, that doomed the GOP’s efforts to repeal and replace Obamacare.
he and his allies crafted a poorly constructed and radical bill that would sharply cut support to low-income Americans and those with serious health conditions, while enacting big tax cuts for the wealthy.
.. Speaker Ryan’s crafting of AHCA was a slapdash enterprise.
.. even leading health-care experts were confused by the changes. As Timothy Jost noted at Health Affairs: “This comprehensive a repeal of the ACA would have far-ranging consequences for our health care system that can scarcely be described, much less understood, in the hours that remain before a vote.”
.. wondered whether the game plan was just for the House to pass something—anything—and then let the Senate do the real work.
.. So why did Republicans fail? In a word: insincerity.
.. they might have refined another conservative model, such as Avik Roy’s modifications to ACA exchanges, to turn ACA’s exchanges in a more conservative direction.
.. Secure in the knowledge that they would face President Obama’s veto, Republicans rammed through a succession of extreme repeal-and-replace bills that resembled AHCA’s original draft. These bills excited the Republican base, but would have horrified most other Americans if they ever found sufficient reason to look.
.. Congressional Republicans suffered what George W. Bush might call a “catastrophic success” with Donald Trump’s unexpected victory.
.. leaving people in plans where the “deductibles are so high that it’s really not worth much to them.”
.. He vowed to replace the “failing,” “horrific” Obamacare with “something terrific.”
.. Republican plans are designed around higher deductibles and narrower benefits, not to mention more limited Medicaid.
.. smaller financial subsidies for people with chronic health conditions. That was the clear intention, but Ryan refused to admit it.
.. Many in the GOP, above all President Trump, seemed strangely uninterested in the policy details.
.. To the extent Republicans did have an animating passion, it was to puncture President Obama’s legacy—and to avoid looking foolish by failing to honor their “repeal and replace” rhetoric.
.. For all their endless warnings about how Obama’s signature health law was hurting American families, driving up costs and putting us on the path toward socialism, it turns out they didn’t care enough to put in the work.