Failed Repeal Of Affordable Care Act: What Does It Mean?The U.S. House of Representatives had been scheduled to vote Friday afternoon on the American Health Care Act, a bill that would have repealed and replaced large swaths of Obamacare. House Speaker Paul Ryan and President Donald Trump agreed to pull the bill at the last minute because they didn’t have enough votes to pass it.
Obamacare will remain in place for the “forseeable future,” Ryan said Friday.
Illinois’ hospital community was pleased by the turn of events, having warned that the state could lose $40 billion over the next 10 years in federal Medicaid expansion funding, among other losses.
Starting in 2020, the bill would have effectively frozen Medicaid expansion, a program under which about 650,000 Illinois residents are covered. It also would have changed the way traditional Medicaid is funded. In all, Medicaid covers more than 3 million Illinois residents.
The bill would also have repealed Obamacare’s requirement that everyone have health insurance or pay a penalty.
Hospitals feared the bill would have led to fewer people with health insurance in Illinois, putting consumers’ health at risk and forcing hospitals to eat the costs of caring for more uninsured patients.
Higher costs for hospitals could have meant cuts to services and programs, the Illinois Health and Hospital Association had warned.
Still, A.J. Wilhelmi, president and CEO of the association, said the group knows there’s “room for improvement” within the current system and wants to work with Illinois’ congressional delegation to improve it.
Many Americans have embraced certain parts of Obamacare, such as its requirement that young adults be allowed to stay on their parents’ insurance plans until age 26; its prohibitions on insurers imposing lifetime and annual coverage caps; and its injunction against insurers denying coverage to people with pre-existing conditions, among other things.
But frustration with the law peaked last fall when consumers shopping for coverage on its exchanges found higher prices and fewer options.
Statewide, 2017 rates across all plans on the exchange increased by an average of 44 to 55 percent for the lowest-priced coverage. In Illinois, insurers Aetna and its Coventry brand, UnitedHealthcare and its subsidiary Harken Health, and Land of Lincoln all offered plans on the exchange last year, but not this year.
Consumers also often had a hard time finding exchange plans that included their doctors and preferred hospitals in-network.
“The way it stands today, the costs are too high (and) something needs to be done with the networks to help individuals in all the counties throughout Illinois,” said Frank Vance, owner of EganVance Insurance in Chicago and former president of the Chicago Southland Association of Health Underwriters.
Experts agree that despite not passing a bill, the Trump administration has power to undermine the law in other ways, such as through new rules.
Plus, questions remain about whether insurers will want to continue offering plans on Illinois’ exchange next year. Insurers have until June 21 to decide whether to offer plans on the exchange in 2018.
Whether insurers stay on the exchanges will depend largely on what happens over the next few weeks, said Timothy Jost, a law professor at Washington and Lee University in Virginia and an expert on the Affordable Care Act.
“Insurers don’t know what to expect next, and insurers like stability,” Jost said.
A spokeswoman for Blue Cross and Blue Shield of Illinois, the state’s largest insurer, said in a statement Friday that the insurer is “committed to working with lawmakers, regulators, providers and other health care professionals to ultimately achieve a sustainable and stable individual market.”
Given the remaining uncertainty, the work of consumer advocates and health care leaders isn’t over yet, Peller said. In recent weeks, the bill’s opponents held numerous protests and events across Illinois.
“The folks who support the Affordable Care Act and the folks who are getting lifesaving insurance because of the Affordable Care Act have had an opportunity to get their voices heard and have been heard, but I don’t think things are done for consumers,” Peller said.