Government affairs

On May 4, the House of Representatives passed the American Healthcare Act, H.R. 1628. The vote fell almost exclusively along party lines, 217 to 213, with 20 Republicans joining the entire Democratic delegation in rejecting the bill, including Reps. Biggs (AZ), Coffman (OH), Ros-Lehtinen (FL), Massie (KY), Jones (NC), LoBiondo (NJ), Smith (NJ), Lance (NJ), Donovan (NY), Katko (NY), Turner (OH), Joyce (OH), Meehan (PA), Costello (PA), Fitzpatrick (PA), Dent (PA), Hurd (TX), Comstock (VA), Herrera-Beutler (WA) and Reichert (WA).

The bill seeks to gut the Affordable Care Act, replacing it with sweeping changes that would:

• tax working families’ health benefits
• repeals the expansion of Medicaid to the working poor and imposes $880 billion in future spending cuts that will most adversely affect poor children and disabled Americans
• repeals $660 billion in taxes aimed at wealthy investors, insurance companies and their executives that funded expanded health insurance coverage
• take away coverage from nearly 24 million individuals
• increase out-of-pocket health care costs
• allows states to permit insurance companies to exclude coverage to individuals with pre-existing medical conditions
• allows states to permit insurance companies to cherry-pick which essential benefits it provides (such as maternity care, substance abuse treatment and hospitalization)
• allows states to re-legalize annual and lifetime benefit caps in both individual and employer-provided health plans

House leaders came under fire for failing to hold even a single congressional hearing on the impact of the AHCA and for forging ahead with a vote on the bill before receiving its Congressional Budget Office "score" (a document that outlines its full impact on the American people and the federal budget).

Following House passage, consideration of this legislation to repeal and replace the Affordable Care Act is now in the Senate’s court. The Senate has indicated that it has its own ideas for a bill, signaling that there is insufficient support for the House-passed measure.

“It will be a real big challenge on the Senate side,” Senate Majority Leader Mitch McConnell (R-KY) said. “Congress will continue to act on legislation to provide more choices and freedom in health care decisions.”

Regardless of how the bill is restructured, expectations are that it will struggle to amass the 51 votes necessary for Senate passage, due primarily to a lack of protective language for individuals having pre-existing conditions.

While letter carriers are lucky to have stable health coverage, repeal-and-replace legislation could have future implications on our coverage. NALC will keep letter carriers informed throughout this process.