Despite all-out efforts from President Donald Trump and House Speaker Paul Ryan, the Republican’s proposed replacement for the Affordable Care Act (ACA)—the American Health Care Act (AHCA)—failed to proceed to the House for a vote last month, as leaders of the House of Representatives doubted it wouldn’t garner enough votes to pass. So what exactly did House representatives on both sides of the aisle dislike about the bill?
Here’s a look at what MCOs should know.
Reason #1: Fewer Americans would have healthcare coverage.
Persons with health insurance coverage would be reduced by 14 million in 2018, 21 million in 2020, and 24 million in 2026 relative to current law, according to estimates by the Congressional Budget Office (CBO)—which is intended to provide Congress with nonpartisan analyses for economic and budget decisions.
“With midterm elections on the horizon next year, House lawmakers were likely concerned about the consequences of voting for legislation that could result in so many people losing their coverage in such short order,” says Garrett Fenton, JD, member, Miller & Chevalier, a law firm with a specialty in healthcare. “On the other hand, many in the Republican party—and the Trump administration in particular—tried to downplay the numbers by calling into question the CBO's accuracy, and emphasizing that the lack of a mandate to purchase insurance would result in an increase in the uninsured rate due to many individuals simply choosing not to buy coverage.”
Reason #2: Insurance premiums would rise initially.
There was public backlash to the CBO’s projected 15% to 20% increase in premiums over the next two years,” says Arthur Tacchino, JD, chief innovation officer, SyncStream Solutions, a provider of healthcare reporting and compliance solutions. “Many Americans believe that the ACA’s premiums are just too high and unaffordable. The CBO’s projections did little to convince Americans that premiums would go down.”
This is in spite of the fact that the CBO predicted that by 2026, average premiums for single policyholders in the non-group market under the legislation would be roughly 10% lower than under current law, Fenton says.