House Cancels ACA Repeal/Replace Vote Today

UPDATED Friday, March 24 at 3 p.m.: House Republicans have stopped the vote today on the legislation to repeal and replace the Affordable Care Act amid speculation the bill did not have the 215 votes needed to pass. The decision to pull the vote came after House Speaker Paul Ryan met with President Trump at the White House. While a new vote on the legislation has not yet been announced, House leadership have indicated it could come early next week.

Friday, March 24 at 11:22 a.m.: Legislation that would repeal Obamacare and replace it with a more limited health care program for the uninsured was cleared for debate and votes on Friday in the U.S. House of Representatives by the House Rules Committee. The House voted to begin debate on the GOP’s health care plan Friday, paving the way for a cliffhanger vote late in the afternoon. The Medical Association is closely monitoring the legislation.

House Republican leaders yesterday postponed the vote to repeal and replace the Affordable Care Act fearing the lack of votes to pass the new legislation. Members of the House Freedom Caucus said they needed more changes in the bill to reduce health plan premiums or else they would vote against it.

As of Thursday afternoon, 37 House Republicans, mostly Freedom Caucus members, declared their opposition to the bill, the Washington Post reported. A handful of more moderate GOP members announced their opposition, spurred by proposed revisions that likely would further reduce Medicaid spending and coverage.

Any delay in the House vote would set back GOP plans to pass the bill in both the House and Senate before the Easter recess begins April 7. GOP leaders fear that their members will come under strong pressure to oppose the bill when they return to their districts and face constituents upset about the prospect of losing their ACA coverage.

At least a dozen Senate Republicans have expressed doubts about whether they could support the House bill in its current form. There are big uncertainties about whether provisions to change the ACA’s insurance market regulations would comply with the Senate’s budget reconciliation rules allowing legislation to pass with 51 votes.

Late Thursday the Congressional Budget Office reported that the amended version of the legislation would achieve less than half the budgetary savings of the original bill over a decade, with the same coverage losses. Federal Medicaid spending reductions would dip from $880 billion over 10 years in the original version of the proposed American Health Care Act to $839 billion. But the CBO estimated the revised bill still would result in a similar sharp decline in the number of Americans with health insurance – 14 million more uninsured in 2018 and 24 million more uninsured by 2026.

The Medical Association has been looking at the American Health Care Act from the beginning with an Alabama perspective to determine the impact of the bill on our citizens. Because of that, we have had concerns with the legislation as it was introduced. We would like to encourage more discussions by all parties to move this legislation forward.

U.S. House to Consider Medical Liability Reform Bill

Pending the outcome of the vote on AHCA, the House may consider the Medical Liability Reform Bill. The House Judiciary Committee approved H.R. 1215, the “Protecting Access to Care Act (PACA)” on Feb. 28 by a vote of 18-17. This bill is based on the California medical liability reform law and would limit noneconomic damages to a cap of $250,000, while providing unlimited economic damages. It would also give states the flexibility to increase the cap on noneconomic damages and has language protecting existing state liability reforms.

The AMA has policy in favor of limiting noneconomic damages and supports the bill. House Republican leadership considers this measure to be part of its health care reform efforts. The full House is expected to consider H.R. 1215 during the week of March 27.