Following the House failure to garner enough support for a vote on the American Health Care Act last Friday, it seemed that political leadership would move forward with other administrative priorities, conceding that Obamacare would remain in place after the massive effort to repeal-and-replace the Affordable Care Act. However, some Republican leaders are now suggesting that a new vote will take place next week, though there are few details on a definitive timeline to revisit the GOP healthcare overhaul. Furthermore, this legislative undertaking exposed deep divisions within the Republican party, particularly between the centrist Tuesday Group and the more conservative House Freedom Caucus, with some reports that growing intraparty tensions are threatening progress on healthcare. Some GOP lawmakers have since expressed interest in working with Democrats to reform the law, rather than finding votes from hard-line conservatives, including a recent affirmation to fund cost-sharing reductions which reimburse insurers for providing discounted deductibles for low-income Obamacare enrollees. This move toward bipartisan reform comes alongside a renewed left-wing enthusiasm for single-payer healthcare. Despite the percolating push toward bipartisanship, House Speaker Paul Ryan has reiterated that he does not want to work with Democrats on healthcare.
Meanwhile, GOP legislatures are facing increasing pressure to expand Medicaid. Lawmakers in Kansas have voted to approve Medicaid expansion, suggesting that the nineteen other states that have yet to expand might also reconsider. Governor Sam Brownback vetoed the bill yesterday; however, supporters in the Kansas House and Senate are still hoping to raise public support to gather the additional votes necessary to override the veto. Lawmakers also voted yesterday to keep Arkansas’ hybrid Medicaid expansion for another year, which supports more than 300,000 people in the state. Though the Republican push to repeal the Affordable Care Act failed, certain aspects of the law remain vulnerable, including the Cadillac tax and other Obamacare taxes that could be tackled in the upcoming Republican tax reform drive.
Department of Health and Human Services Secretary Tom Price has also defended proposed cuts to the National Institutes of Health, citing that its budget is rife with unnecessary expenses. The administration has proposed an additional $1.2B cut to the NIH for its current fiscal year, on top of a suggested $5.8B cut for 2018. This has spurred fierce nonpartisan opposition, including from Ann Romney, wife of former Republican presidential candidate Mitt Romney, who affirmed that NIH funding is critical to medical innovation and scientific progress.
And in the midst of pervasive health law uncertainty, insurers are still struggling to chart their path forward in the individual markets next year, seeking more clarity from the Trump administration as the deadline for submitting 2018 plans and rate requests looms. Anthem has signaled that they are likely to exit Obamacare’s individual insurance markets, leaving consumers in parts of Colorado, Kentucky, Missouri and Ohio at risk of having no Obamacare insurers for next year. The Justice Department has also joined a whistleblower lawsuit against UnitedHealth Group, claiming that the company committed fraud in its popular Medicare Advantage plans, and has also stated that it will investigate risk-score payments to other Medicare Advantage insurers.
MEMBERS IN ACTION
JAMA Infographic: US Public Opinion on Health Care Reform, 2017
TIME: Some Democrats Say They’ll Vote to Confirm Neil Gorsuch to the Supreme Court
Christopher Jacobs: “To Overcome the Obamacare Repeal’s Failure, Let’s Understand its Causes”
Bloomberg: House GOP Weighing Another Try on Obamacare Next Week
Wall Street Journal: After GOP Bill’s Failure, Health-Law Lawsuit Takes Center Stage