On May 4 the U.S. House of Representatives narrowly approved HR 1628, the American Health Care Act (AHCA), by a vote of 217-213. All but 20 House Republicans voted in favor and all Democrats voted against the bill. Wisconsin’s House Members split on party lines with Republicans Sean Duffy, Mike Gallagher, Glenn Grothman, Jim Sensenbrenner and Paul Ryan voting in favor while Democrats Ron Kind, Gwen Moore and Mark Pocan voted against.
“Wisconsin’s hospitals are the safety net of our health care system, where the uninsured turn to, and receive, care when they are unable to obtain needed care anywhere else. This is why WHA’s top priority, top ACA-related concern, has been sustaining the coverage gains, the 38 percent reduction in our uninsured we have achieved since 2014 under our hybrid model of coverage,” said WHA President/CEO Eric Borgerding. “While the ACA certainly has flaws and needs repair, we remain very concerned with the impact the AHCA will have on our uninsured rate and the success of the highly-touted ‘Wisconsin Model’ in expanding coverage to our most vulnerable low income and aging populations.”
An earlier vote scheduled in late March was canceled due to lack of votes. While there were various issues in play at that time, the disagreement boiled down to moderate Republicans expressing concerns with various AHCA provisions impacting coverage options and costs for individuals versus “Freedom Caucus” conservatives who wanted the bill to go even further, such as rolling back the Affordable Care Act’s insurance requirements. Various amendments popped up over the course of the last month, including several in the last week, which allowed Republican leadership to cobble together just enough votes to pass the bill.
The House-passed amendments allow for states to waive insurance coverage requirements, such as essential health benefits and community rating, as well as to provide an additional $8 billion in funding for high risk pools to help individuals with pre-existing conditions. WHA does not believe the AHCA nor these amendments adequately address or protect Wisconsin’s unique coverage model.
While the bill now moves to the U.S. Senate for action, many Republican senators have already gone on record expressing concerns with the House legislation. With no Democratic senators expected to vote in favor of the AHCA, Senate Republicans can only lose two votes, which makes prospects in the Senate that much more difficult.
“WHA will continue to work with both state and federal lawmakers to protect the Wisconsin Model as debate now shifts to the U.S. Senate,” Borgerding said. “In fact, I am heading to the airport right now bound for Washington, D.C.”
The Wisconsin Hospital Association will continue to advocate to both U.S. Sen. Ron Johnson and Tammy Baldwin that necessary improvements to the AHCA are needed. In particular, WHA and our members continue to be concerned with ensuring affordable coverage for low-income and high-risk populations.