There have been rumblings a discussion draft for the Affordable Care Act repeal bill is circulating, but opposition toward a Republican-crafted health care law continues to mount — and not just from the usual suspects.
According to The Hill, the American Health Care Act originally had 38 percent voter approval when it passed in the House on May 4, but that has now dipped to 35 percent. As for those who disapprove, the Politico/Morning Consult poll showed 44 percent weren’t fans back in May, rising to 49 percent voter disapproval this week.
Much has been said surrounding the secrecy of GOP senators’ revision of the AHCA, but the poll shows only 18 percent of respondents believe Republicans should work only with their party on health care. The majority, 65 percent, think Republicans should reach across the aisle to find compromise on bipartisan reform.
Trouble in party paradise?
Most notably, Senate Majority Leader Mitch McConnell has been lambasted for the clandestine state of the new bill. He fought back, saying once the bill is unveiled, it will also be given to reporters to review. It sounds like a step in the right direction, but with McConnell pushing for a vote as early as next week, an adequate review of the bill seems daunting, even for those within in his own party.
As reported by CNN, Republicans like Maine’s Susan Collins, Florida’s Marco Rubio, Alaska’s Lisa Murkowski, Tennessee’s Bob Corker, Wisconsin’s Ron Johnson, and Arizona’s John McCain have all had problems with the latest effort to rewrite the bill for a Senate vote.
“I think it’s much better to have committee consideration of bills, public hearings, and to have a full debate,” says Collins.
“If it is an effort to rush it from a small group of people straight to the floor on an up-or-down vote, that would be a problem,” says Rubio.
“If I’m not going to see a bill before we have a vote on it, that’s just not a good way to handle something that is as significant as and important as health care,” says Murkowski.
“The process is better if you do it in public, and that people get buy-in along the way and understand what’s going on,” says Corker. “Obviously, that’s not the route that’s being taken.”
“They used to complain like hell when the Democrats ran the Affordable Care Act. Now, we’re doing the same thing,” McCain says.
Johnson took his criticism of not only the secrecy, but also of the limited review time, to another level by saying his vote is not guaranteed.
“I can’t imagine, quite honestly, that I’d have the information to evaluate and justify a yes vote within just a week," he says.
According to The Hill, Johnson shared this sentiment with McConnell, saying he wants input from his constituents and a full public vetting of the bill.
While the AHCA can pass with a 51-vote majority, that doesn’t give McConnell a big margin of error: Lose two “yes” votes, and the bill dies. (Of course, should it come down to a split, Vice President Mike Pence will lodge the tiebreaker, and we all know how that will go.)
What about the voters?
A study from the University of Maryland’s Program for Public Consultation also examined voter opinions regarding the GOP legislation.
“While Senate Republicans move toward finalizing their health care plan, a new in-depth survey finds that all of the key provisions of the House-passed American Health Care Act are opposed by clear majorities,” the press release reads. “Overall, 67 percent oppose the legislation.”
The study breaks down voters by congressional districts in six ways, ranging from the most Republican districts to the most Democratic. Even in the most red districts, the study says, “majorities oppose nearly all of the key provisions and 63 percent oppose it overall.”
Other findings from the study, which was conducted June 8-13 from 2,430 registered voters, include specifics on a number of ACA provisions.
Pre-existing conditions: 6 of 10 Republicans oppose state waivers which would empower insurers to charge more or not cover those with pre-existing health conditions. Three-quarters are opposed in very red districts, and over 8 of 10 are opposed in very blue districts.
Higher premiums for older Americans: The least popular provision of the bunch with two-thirds of Republicans are opposed, 8 of 10 in very red districts also disapprove.
Essential benefits: While a majority of Republicans are in favor of the AHCA allowing insurers to not cover certain benefits, 6 of 10 in very red districts and 8 of 10 Democrats oppose the measure.
Individual mandate: The report saw the highest level of support for the AHCA provision to replace the ACA health care mandate, but that said, support is only 44 percent with 55 percent opposed. Party breakdown shows 53 percent of Independents and 79 percent of Democrats are opposed, while 71 percent of Republicans favor the proposal.
Health care for low-income population: The majority of respondents take issue with the AHCA’s reduced Medicaid spending (55 percent), Medicaid expansion repeal (53 percent), out-of-pocket costs (59 percent), and the repeal of taxes on those with higher incomes (53 percent).
Employer mandate: Opposition toward the AHCA reversal of requiring employers with more than 50 employees to provide health insurance is 62 percent of Independents and 86 percent of Democrats. Fifty-nine percent of Republicans favor the AHCA’s repeal of this provision.
Planned Parenthood: The majority of respondents (67 percent) disapprove of the AHCA proposal which would not allow Medicaid benefits to be used at Planned Parenthood clinics, with 61 percent in very red districts opposing this. That said, 63 percent of Republicans favor it.
Decision time for insurers
As June 21 comes and goes, so does the window for insurers to determine if they’ll file plans for HealthCare.gov next year.
That may be a hard decision to make, especially since many insurance companies are still wondering if the Trump administration will offer subsidies to curb costs of insuring low-income customers.
Earlier this week, the White House said it would make the payments for June, but after that is anyone’s guess.
The lack of clarity, as reported by Politico, is creating even more of an uneven ground for the already-wobbly insurance landscape. With insurers dropping out of state marketplaces left and right, many Americans will be left without options for insurance coverage.
As Politico points out, another factor in the ongoing uncertainty comes in the individual mandate. With no finalized health care reform bill, no one knows the fate of the provision which required Americans to have health insurance or face penalties.