A look at the proposed American Health Care Act

President Donald Trump ran much of his campaign on the promise of repealing and replacing the Affordable Care Act commonly known as Obamacare, but now that his party has the power to make a change, several opposing factions in the Republican party have developed.    

Speaker of the House Paul Ryan introduced the Republican’s alternative to Obamacare on March 6. Known as the American Health Care Act (AHCA), the bill laid out the Grand Old Party’s (GOP) plan to “repeal and replace”   the Affordable Care Act, but it also forced several legislators to consider their stance on health care and the government’s job in regulating it.

In the past, President Trump has attacked Obamacare as a weak bill that has only harmed America, but much like the original goal of the Affordable Care Act, his objective was to “take care of everybody.”     The recently introduced bill, however, falls short of that objective.

The Congressional Budget Office, a nonpartisan agency, recently released its report on the short-term and long-term effects of the proposed AHCA (CBO).  Its estimates claim that the new bill would save $337 billion over the next nine years; however, that comes at the expense of 14 million people losing coverage by 2018 and 24 million total by 2026.

For my First Year Seminar at Saint Joseph’s University, I took Global Healthcare with Professor of Pharmaceutical and Healthcare Marketing William Trombetta, Ph.D., and in summary, there was one main takeaway from this course: healthcare is extremely complicated.  We studied many specifics of healthcare—from the individual types of plan to the comparative data on countries. Every individual has their own health care needs and wants, so there is no one-size-fits-all approach. President Trump even recently admitted this himself.

Whether it is universal health care provided by the state or privatized health care paid for entirely by citizens, there is no objectively correct way to do health care.  It is a matter of needs and preferences.  Politicians and pundits often simplify the complexities of healthcare into bit-sized problems and solutions, but in practice, the policies regarding healthcare are immensely complicated.

Even before the recent CBO analysis, some Republicans claimed that specific provisions of the proposed bill did not live up to the requirements to repeal and replace.  Some felt that the bill was too federalized and others felt that it did not provide enough to cover citizens.  The specificities of the bill have driven a divide among many Republican legislators and pose an increased opportunity for the failure of the bill.

Now presented with the power to actually make a change, this fracture of opinions regarding the bill has led to an identity crisis regarding healthcare for the GOP.  It was easy for party officials to criticize Obamacare for the past eight years, while they were in the minority. Now the Republicans are the ones writing policy and changing several years of existing law.

This is the first significant test for the party under the new administration and they are divided to the point of potential failure. They can only afford so many Republican defectors and public criticism of the bill could cause many representatives to reconsider their stance on healthcare.

Although they were critical of many characteristics of Obamacare, such as the individual mandate or the limits on how much insurance companies can charge, the currently proposed bill keeps many aspects of the old bill and only slightly modifies others.  A party that has spent the past administration critiquing the bill and claiming to want great change now finds itself in the difficult situation of determining what healthcare should look like in the United States.

Several have already come out publically against the bill, but one thing is for certain—after many years of criticizing the Democrats for their healthcare policy, the Republicans need to unite their party behind some version of the bill.  If the bill fails, it will be a significant sign of failure early on in an already unstable administration.