A Portland, Maine man holds a sign in support of Sen. John McCain Friday morning. (Photo by Henry Powderly)
To the relief of providers, senators late last night rejected the skinny repeal of the Affordable Care Act when Republican Senator John McCain cast the deciding vote against the legislation that would have ended the individual and employer mandates.
While not making the cuts to Medicaid that previous Senate bills proposed, the skinny repeal in the Health Care Freedom Act - unveiled only hours before the vote - was not a solution, according to Bruce Siegel, MD, president and CEO of America's Essential Hospitals.
"While it doesn't directly affect Medicaid, it still would badly undermine coverage and access by destabilizing the private marketplace," Siegel said. "Estimates are the skinny option would cause 16 million people to lose coverage, including 7 million current Medicaid beneficiaries. It also would drive up uncompensated care at hospitals, as people leave the insurance market and, instead, rely on costly emergency departments for their health care needs."
The American Medical Association too, breathed a sigh of relief and said it was looking to what's next.
"While we are relieved that the Senate did not adopt legislation that would have harmed patients and critical safety net programs, the status quo is not acceptable. We urge Congress to initiate a bipartisan effort to address shortcomings in the Affordable Care Act," said AMA President David O. Barbe, MD. "The first priority should be to stabilize the individual marketplace to achieve the goal of providing access to quality, affordable health coverage for more Americans."
America's Health Insurance Plans said insurers stand ready to work with Congress and the administration to ensure Americans have affordable, high-quality coverage.
On Thursday, AHIP CEO and President Marilyn Tavenner sent a letter to Senate Majority Leader Mitch McConnell and Senate Minority Leader Charles Schumer saying that while the status quo is not sustainable, ending the individual coverage requirement is not the solution to stabilize the market. In fact, it would result in higher premiums.
Siegel said what's next is legislators to head back to the drawing board for a bipartisan solution.
American Hospital Association President and CEO Rick Pollack is also urging for a bipartisan answer on what he called the critical task of repairing our healthcare system.
McCain tweeted after the vote, "Skinny repeal fell short because it fell short of our promise to repeal & replace Obamacare w/ meaningful reform."
"We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of the aisle, heed the recommendations of nation's governors, and produce a bill that finally delivers affordable health care for the American people," McCain said by statement.
Senate Majority Leader Mitch McConnell said from the floor, "It is time to move on."
In a tweet, President Trump said,"3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let ObamaCare implode, then deal. Watch!"
McCain and Republican Senators Susan Collins of Maine and Lisa Murkowski of Alaska voted against the bill.
The Health Care Freedom Act would have repealed the individual and employer mandate penalties, extended the moratorium on the medical device tax, increased the maximum contributions allowed to healthcare savings accounts, banned Planned Parenthood funding for one year and eliminated the Prevention and Public Health Fund starting in 2019, according to the Congressional Budget Office score.
It would also have allowed $2 billion in pass-through funding for states to implement ACA section 1332 state innovation waivers and extended those waivers from 5 to 8 years. The waivers allow states to waive ACA provisions such as essential health benefits, but mandates coverage as comprehensive.
The bill would have increased the number of uninsured by 15 billion, increase premiums by about 20 percent by 2026 and reduced the deficit by $135.6 billion, the CBO said.