When I started writing this post it was going to be titled “Problems Facing the AHCA” but by the time I got on my lunch break at work that same day, Paul Ryan had already pulled the bill because there would not be enough votes for it to pass.
For the past eight years, republicans in Congress have vowed to “repeal and replace” the ACA. Now that their party has control of the House, Senate, and Presidency, they now have the power to fulfill this bill. Recently several members of congress, including Speaker of the House Paul Ryan have come out with their own healthcare bill. They were unable to pass this bill, however because of a divide in the Republican party about how large of a role the government should play in healthcare and, for those who want full repeal, how much of the ACA they can repeal now.
While normally I would discuss the specifics of the bill, I felt it more worthwhile to talk about why republicans are having trouble passing this bill, since the bill was often being altered.
On Thursday, congress held an emergency meeting to discuss changes that could be made to the AHCA, in order to make it more likely to pass. They faced the problem that is common when you try to appeal to many peaple, when you give in to one side you get less support from the other. In this case, it was moderate republicans and the House Freedom Caucus (the most conservative part of the house).
The HFC wants the bill to remove more of the insurance mandates that are part of the ACA, the reason that this has not been done is because the House is using budget reconciliation to pass the bill. if there are “extraneous” parts of the bill (such as repealing non-budgetary parts of the ACA) then the bill will not be able to go through as a budget reconciliation and would likely not pass in the senate.
If the bill had passed in the house as a budget reconciliation then it would have only needed a simple majority (51 votes) in the senate, but if it was changed in way that no longer qualified it for a budget reconciliation then it would have to get sixty percent of the vote and would be open for filibustering. Given that Republicans only hold fifty-two seats it is highly unlikely that it would have passed the senate if it was not submitted as a budget reconciliation.
The HFC argued that it was possible to put in the items they wanted and still vote on the bill as a budget reconciliation. They refused to vote for the bill if Ryan and others did not add their demands to the bill. This was one of the largest factors in passing the AHCA, and since they were not able to get what they wanted in the bill they decided that they would vote against it.
Since the failure of this bill, there have been multiple arguments as to what will happen next and even the White House has presented two opposing paths forward, Trump working with democrats to craft a new healthcare bill or just letting the ACA “explode”. I will not theorize in this post about what comes next. This bill shows that it will be hard for Republicans to pass their own healthcare bill because of the growing schisms in the party. It will be interesting to see how this party divide will effect future bills.