It’s back and scarier than before.
After being pulled from being voted on by the full House of Representatives a month ago because it faced certain defeat, The American Health Care Act (AHCA), has been revived with a new amendment and the Republican leadership is again trying to move the bill towards a House vote. The original bill was the vehicle for congressional Republicans, with the support of President Trump, to repeal and replace the Affordable Care Act. (ACA). The AHCA would have shattered health coverage for millions of Americans and would have had a cruel, punishing impact on health care for many thousands of people living with HIV and other chronic conditions. Hard to believe, but the revised bill is even more harmful.
The AHCA’s (H.R. 1628) new lifeline comes via an amendment offered by Rep. Tom McArthur (R-NJ). The House Freedom Caucus, a group made up of 30+ of the most conservative House Republicans (the caucus does not reveal the names of its members) has officially endorsed the amendment and now supports passage of the amended AHCA. Many Freedom Caucus members opposed the original bill and were a key factor in the bill’s collapse. With House Democrats remaining solidly opposed, the fate of the amended bill hinges on the vote of moderate and centrist House Republicans, several of whom opposed the original bill. There had been widespread speculation that a House vote on the amended bill would take place Friday or Saturday. By Thursday night, however, the Republican leadership was saying a vote would not take place until next week at the earliest. The leadership also made clear that the bill would not be taken to the House floor until leadership had enough votes for passage.
The amended bill retains the devastating provisions of the original, which would cause 24 million people to lose health coverage over ten years, drastically restructure Medicaid to end it being an entitlement program, reduce funding for Medicaid by $800 billion over 10 years, and use much of the savings to give tax cuts to wealthy individuals and families.
The McArthur amendment ostensibly continues to protect people with pre-existing conditions from being denied health coverage and continues the federal standard for Essential Health Benefits. These protections in the amendment are wafer thin, however, because the amendment allows states to apply for a waiver that would make it easier for insurance companies to raise rates on people living with HIV, people with other chronic conditions, and older adults. The proposed solutions include high risk pools, which repeatedly have failed people living with HIV and other chronic conditions. Coverage in high risk pools often has excessively high premiums, deductibles, and co-pays along with limitations on needed drug coverage and care.
Under the amendment, states also could apply for a waiver that would allow insurers to offer plans that exclude coverage for Essential Health Benefits such as maternity coverage, prescription drugs, or mental health treatment.
A bad bill has been made worse.
One of the prime reasons the original bill collapsed was the tremendous mobilization of grassroots opposition. Thousands and thousands of people across the country told their Congress members that the AHCA was not acceptable. We need to mobilize again to stop this “zombie” bill. As one House Democratic leader said, we cannot let health care security for millions of Americans to be snatched away. For HIV advocates we cannot allow a return to the pre-ACA days when too many people living with HIV could not obtain or afford health care coverage and people vulnerable to HIV infection did not have coverage for prevention services.
We need to act now. Go to AIDS United’s Policy Action Center to take action [insert link to action alert] and let your representatives in Washington know that any health care reform that fails to protect people living with HIV and makes quality, affordable health care unattainable for millions of Americans is unacceptable.