If passed, will it raise premiums? Will millions of people lose insurance coverage? How can Republicans support a bill with such a terrible score from the Congressional Budget Office? Is there any path forward for the bill after it was panned by interest groups and Republican lawmakers?
Not least, some are wondering how to even pronounce AHCA — the acronym for the American Health Care Act.
On the latest episode of The Weeds, devoted solely to AHCA, Vox’s Ezra Klein, Matt Yglesias, and Sarah Kliff tackle these questions, analyzing the Republican plan’s proposed changes to subsidies, Medicaid, insurance regulations, and actuarial value. They also discuss the politics of getting the bill through Congress, and the likelihood of it passing.
Here’s Sarah and Ezra on the swift and negative reaction the bill received, and what that means for its chances of becoming law.
SARAH: One of the things that has struck me is just the negative reception to this bill. It’s not just the conservatives; it’s also the more moderates. You have [Sen.] Susan Collins [R-ME] saying she can support the bill in its current form because it might leave people uninsured. You have ... the American Hospital Association opposes this bill. The American Medical Association came out today in opposition.
EZRA: Which is bad. You do not want the hospitals against this, because there’s a hospital in every district.
SARAH: The insurance companies have not said anything about this bill, which I think is kind of a notable silence.
EZRA: Like they just haven’t seen it yet. Everybody’s been off this week.
SARAH: Right, they’re at a staff retreat. I’m sure that’s what’s happening.
One of the things Obama did, and he was criticized for it, was he did a lot of deals and compromises and meetings with industry to make sure when the bill came out, they wouldn’t be vociferously in support but they would at least not trash it right away. And none of that has gone on here. I have gotten one positive press release — no, I’ve gotten two positive press releases about the Republican bill. One is from the United States Chamber of Commerce; the other is from the National Retail Federation. That’s it. Those are not health care organizations.
And it makes me kind of wonder how much Paul Ryan actually wants this bill to pass, or how much he just wants to move as quickly as possible away from this and blame it on procedure or something and decide, “We’re just going to move on to tax reform.” Because the way I see it, he’s kind of staring down two undesirable choices. One is pass a bill that kicks millions of people of their health insurance. The second is not deliver on a campaign promise. I mean, neither of those are great, but it could be possible that the not delivering on a campaign promise feels a little bit better at this point, and why not just move as quickly as you can away from it? Pass some small executive orders, and say you’ve done some things, and call it a day.
- Sarah’s explainer on AHCA
- Vox’s chart showing the major critics of bill
- Sarah on the similarities and differences of this process and Democrats trying to pass the Affordable Care Act in 2009-’10
- How Senate rules might force Republicans to drop key provisions of AHCA
- For our full coverage and updates on the AHCA, check back here
- And be sure to sign up for VoxCare, a new nightly newsletter covering all things health care, with Sarah Kliff as lead writer and contributions from Ezra, Andrew Prokop, and Julia Belluz