House vote on ACA replacement postponed

House Republican leaders have chosen to call off a planned vote on the American Health Care Act (AHCA), their replacement for the Affordable Care Act (ACA), as last-minute revisions and negotiations failed to guarantee enough support to pass the bill.

First reported by the Associated Press, leaders now officially hope to reschedule the vote for March 24. The March 23 date, set last week, had symbolic value as the seventh anniversary of the ACA’s passage. POLITICO has reported there’s no guarantee of a vote on the legislation in the near future, with one unnamed congressional aide saying, “We’re still talking to members.”

In an effort to gain support from the conservative House Freedom Caucus, President Donald Trump had met with the group Thursday morning. One option floated to win their votes was eliminating the ACA’s requirements for insurers to cover 10 essential health benefits: outpatient care, emergency services, hospitalization, maternity care, mental health, prescription drugs, rehabilitation, laboratory services, preventive care and pediatric services.

“The group agreed that their ultimate goal is to implement a system that will drive down costs and increase access to healthcare for millions of Americans,” read the official White House summary of the meeting.

However, the chairman of the caucus, Rep. Mark Meadows, R-North Carolina, told reporters afterwards that “no deal” had been reached. The potential elimination of essential health benefits, previously believed to be off the table in the AHCA, led more moderate Republicans, like Pennsylvania Rep. Charlie Dent, to declare they wouldn’t vote for the bill.

Republicans could only afford to lose 22 of its own members to pass the bill, with Democrats assumed to be united in opposition both in the House and the Senate.

Most major medical organizations had either declined to support or urged rejection of the bill ahead of the scheduled vote. Among them was American Medical Association (AMA), which in a March 22 letter said the bill’s effects on insurance coverage were unacceptable.

“The need to stabilize the individual insurance market and make other improvements in the Affordable Care Act is well understood,” wrote AMA CEO James Madara, MD. “However, as physicians, we also know that individuals who lack health insurance coverage live sicker and die younger than those with adequate coverage. We encourage all members of Congress to engage in an inclusive and thorough dialogue on appropriate remedies. We cannot, however, support legislation that would leave health insurance coverage further out of reach for millions of Americans.”

There hasn’t been an updated report from the Congressional Budget Office (CBO) since the bill was altered on March 20, introducing options for states to establish work requirements for Medicaid benefits among other changes. The CBO’s original estimate said the AHCA would result in 24 million more people lacking health insurance by 2026.