House narrowly approves AHCA

The U.S. House of Representatives on Thursday narrowly approved the American Health Care Act (AHCA) by a vote of 217-213 on Thursday.

The Republican-sponsored legislation crafted to replace many policies put into place by the Affordable Care Act of 2010 now heads to the Senate, where plenty of work remains for the GOP, according to Julius Hobson, the former head of Congressional relations for the American Medical Association.

“The reality is the bill that passed the House has no chance of becoming law because the Senate has made it clear it will not pass that bill as is,” says Hobson, who now serves as a healthcare lobbyist and attorney with the Polsinelli law firm. “They will make substantial changes. Any changes they make will be to the left of what the House did.”

As for the version of the AHCA that passed through the House on Thursday, Hobson tells Behavioral Healthcare Executive that although a Congressional Budget Office cost estimate of the bill has not been released, he expects fewer individuals with pre-existing conditions to be covered.

“The concept of a high-risk pool to cover those kinds of people [with pre-existing conditions] is extremely expensive,” says Hobson. “The one thing the Affordable Care Act did was it dumped everybody into the insurance pool, individuals as well as groups. That spread the risk. It slowed down the increases in health insurance. That would change if this became law.”

Linda Rosenberg, president and CEO of the National Council for Behavioral Health, said in a statement that the AHCA could be particularly harmful for those on Medicaid.

“The National Council for Behavioral Health is outraged that the House passed the American Health Care Act, which puts the lives of those who rely on Medicaid for lifesaving addiction and mental healthcare in jeopardy,” Rosenberg said. “The final amendments did nothing to mitigate its disastrous effects. We urge the Senate to do what the House of Representatives did not—stand up for what is right and ensure that the millions of Americans facing mental illnesses and addictions who currently get care under the Affordable Care Act are not left out in the cold.”

Sylvia M. Burwell, former Secretary of the U.S. Department of Health and Human Services, called the House vote “a setback for our nation’s health system” in a statement, noting that an estimated 24 million Americans could stand to lose health insurance coverage. Describing the bill as “harmful” and “partisan,” she called on the Senate to instead focus its attention on “constructive, bipartisan improvements to our health system.”

“Premiums and out-of-pocket costs would increase, especially for low-income, older, and rural Americans,” Burwell said of the AHCA in her statement. “Millions of Americans would be segregated into high-risk pools and charged more for the misfortune of being sick. This bill does not protect people with pre-existing conditions, and it would block women from accessing basic preventive care. And it does not improve the quality of care. In fact, it takes us backwards on making prescription drugs affordable and addressing the opioid epidemic.”