Following the Trail of the Affordable Care Act Debate: Part 8

Health Insurance
By Zach Cahill and David White

The Affordable Care Act (ACA) is here to stay, for now. When our last edition of Following the ACA was published last Friday, there was still a chance for a vote on the American Health Care Act (AHCA). However, the Republican repeal/replace bill was pulled from the House floor Friday afternoon – an undeniable sign that the AHCA did not have enough Republican votes to pass through the House of Representatives.
In a press conference following the decision to pull the bill, House Speaker Paul Ryan said that “Obamacare is the law of the land” and that the House was moving on to tax reform. Over the past week leadership has hinted that they might revisit the ACA in the short term. However, the attitude of rank and file members, who killed the bill last week, has not changed. This leads us to believe that the remaking of the American health care system that we have been anticipating for weeks is, at least, indefinitely postponed.

Medicaid Expansion Questions

Many healthcare observers are now pointing to the states as the primary actors in the health care debate going forward. For instance, the continued future of the ACA has prompted many states to revisit Medicaid expansion. Kansas passed a bill to expand Medicaid this week that was vetoed by Republican Governor Sam Brownback; however, a vote to overturn the veto is expected. Virginia governor, Terry McAuliffe, also plans on revisiting Medicaid expansion in Virginia’s House of Delegates. At the time of publishing, 18 states have not yet expanded Medicaid. 

"Obamacare Dead Zones"

There is still work going on in Washington around the periphery of the ACA. On Wednesday, Tennessee Senators Lamar Alexander and Bob Corker introduced legislation aimed at providing assistance in “Obamacare dead zones” where customers have no insurance plans to choose from. With Humana pulling out of the Tennessee market in 2018, about 40,000 people in the east Tennessee city of Knoxville will be without an insurance option in the individual market. The bill would allow individuals to use their exchange subsidies to purchase plans off the exchange, an action currently prohibited. Additionally, the law waives the individual mandate penalty for people in the one-third of American counties without an individual insurance option on ACA exchanges.

Continued Activity

We also expect some administrative action from Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Director Seema Verma impacting the Affordable Care Act’s administration. When significant actions occur in the regulatory arena, we will keep you informed in this space. 

The Republican fight against the ACA has reached an uncertain hiatus after nearly two months of frenetic activity and speculation. Expect periodic updates to our Following the ACA series when events heat up again. Until then, thank you all for following our ACA coverage in Kidney News Online. If you have any questions about the series or ASN’s advocacy for you on Capitol Hill, do not hesitate to contact us or post your question on ASN Communities.

Following the Trail of the Affordable Care Act Debate: Part 1Part 2Part 3Part 4Part 5Part 6, Part 7

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The Affordable Care Act (ACA) is here to stay, for now. When our last edition of Following the ACA was published last Friday, there was still a chance for a vote on the American Health Care Act (AHCA). However, the Republican repeal/replace bill was pulled from the House floor Friday afternoon – an undeniable sign that the AHCA did not have enough Republican votes to pass through the House of Representatives.
In a press conference following the decision to pull the bill, House Speaker Paul Ryan said that “Obamacare is the law of the land” and that the House was moving on to tax reform. Over the past week leadership has hinted that they might revisit the ACA in the short term. However, the attitude of rank and file members, who killed the bill last week, has not changed. This leads us to believe that the remaking of the American health care system that we have been anticipating for weeks is, at least, indefinitely postponed.

Medicaid Expansion Questions

Many healthcare observers are now pointing to the states as the primary actors in the health care debate going forward. For instance, the continued future of the ACA has prompted many states to revisit Medicaid expansion. Kansas passed a bill to expand Medicaid this week that was vetoed by Republican Governor Sam Brownback; however, a vote to overturn the veto is expected. Virginia governor, Terry McAuliffe, also plans on revisiting Medicaid expansion in Virginia’s House of Delegates. At the time of publishing, 18 states have not yet expanded Medicaid. 

"Obamacare Dead Zones"

There is still work going on in Washington around the periphery of the ACA. On Wednesday, Tennessee Senators Lamar Alexander and Bob Corker introduced legislation aimed at providing assistance in “Obamacare dead zones” where customers have no insurance plans to choose from. With Humana pulling out of the Tennessee market in 2018, about 40,000 people in the east Tennessee city of Knoxville will be without an insurance option in the individual market. The bill would allow individuals to use their exchange subsidies to purchase plans off the exchange, an action currently prohibited. Additionally, the law waives the individual mandate penalty for people in the one-third of American counties without an individual insurance option on ACA exchanges.

Continued Activity

We also expect some administrative action from Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Director Seema Verma impacting the Affordable Care Act’s administration. When significant actions occur in the regulatory arena, we will keep you informed in this space. 

The Republican fight against the ACA has reached an uncertain hiatus after nearly two months of frenetic activity and speculation. Expect periodic updates to our Following the ACA series when events heat up again. Until then, thank you all for following our ACA coverage in Kidney News Online. If you have any questions about the series or ASN’s advocacy for you on Capitol Hill, do not hesitate to contact us or post your question on ASN Communities.

Following the Trail of the Affordable Care Act Debate: Part 1Part 2Part 3Part 4Part 5Part 6, Part 7

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