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ACA Deathwatch: No, AHCA is not going to pass Congress

AHCA is not going to become law.

IF it passes the House, there’s no way it gets enough votes in the Senate.  Two reasons.

  1. Senate Republicans are opposed to the bill.
  2. Enacting AHCA without massive changes would alienate core Trump voters.

Passing AHCA – without drastic changes – would be political suicide for politicians who voted for passage. And while pre-existing condition coverage is a big issue, the big issue is loss aversionmillions of Trump voters would lose coverage under AHCA.

The biggest winners – young, healthy people – don’t vote.

Oh, and AHCA keeps current ACA subsidies and protections for Congress and Congressional staff while chopping both for regular Americans

This from Nate Silver:

Republicans whose families make less than $30,000 a year were nearly three times more likely than those in families making at least $75,000 to say it was the government’s responsibility ensure Americans had health care coverage.

And from Jonathan Cohn – voters who stand to lose the most in insurance subsidies under AHCA are – by a wide margin – Trump voters…

Subsidy amounts lost by voters in 2016 election

AHCA drastically cuts assistance to older, lower-income Americans in rural areas, a demographic that overwhelmingly supported Trump. And, most of these voters earn too much to qualify for Medicaid, so they’ll be left:

  • with far lower subsidies
  • without coverage for pre-existing conditions
  • facing insurance premiums that are much higher than today’s because AHCA allows insurers to charge older folks much higher premiums.

Some may cynically hope AHCA passes as it will doom the GOP in the 2018 elections. But the cost of that political calculation is far too high; the millions will lose coverage are those most in need of healthcare coverage.

Of course, Congress won’t suffer – they keep subsidies, pre-ex coverage, and all the other goodies.

8 thoughts on “ACA Deathwatch: No, AHCA is not going to pass Congress”

  1. Again, Joe, I hope your predictions are right. The Rs have been hell bent on repealing and replacing the ACA. They have not done the work they needed to ensure the ‘new’ law meets the needs of ALL of their constituents. I am a Brain Tumor Survivor and will be among those with pre-existing disease. The rates for insurance are already out of control for most people, this new version will put access to HC out of reach for many. The winners will be the Insurance Companies will continue to rake in high premiums. Specialists and those in the C-Suite who are charged with implementing the law…..I will hold my members of Congress and the Senate responsible for this mess for sure.

  2. Joe, you biggest assumption is misguided.

    You assume elected representatives govern using logic and reason to make the best public policies based on what’s best for citizens.

    1. Hi Brandon – thanks for the note. Much as I wish they did what they are supposed to do, my core assumption is that elected representatives will not do stuff that will completely piss off the group that elected them.

      Yet here we are.

  3. Somethings got to give. I used to have an HMO with $15 co-pays. Now my rates are horrible with a $5,000 deductible. Needless to say, I haven’t seen my doctor in over a year. I can’t afford to. That’s just not healthy. There’s got to be efforts to increase the supply of doctors, nurse practitioners, ReadyMeds… We can’t just keep throwing money at problems. We’ve run out!

  4. We need government out of this business and fast. This is not really insurance but another hybrid welfare scheme. If the Federal governor is internationally in providing healthcare then build the infrastructure and hire the professionals, providers and allied health and they shall come.

    1. The government has been involved in health care since the passage of Medicare and the VA. Tack on Medicaid and now fully half the population is in government healthcare plans. This bill is nothing more than a multi-billion dollar tax cut for the existing billionaires. Cause they need new yachts more than the country needs health care apparently.

  5. Now that it’s passed in the House, it’s on to the Senate where Mitch McConnell will kill the legislative filibuster to pass this monstrosity on party lines. All health insurance is now in jeopardy, including employer based health care. That’s what happens when we let those who know nothing about the industry manage it.

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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