Micah De Voe

Dr. Ericka Cornelius Smith

PCI 315 ON2
07/22/2017

Policy Brief #1

The American health care act is the GOP attempt to keep partisan promises to repeal and

replace the Patient Protection and Affordable Care Act, more commonly referred to and known

as Obamacare. The American Health Care Act (AHCA) is designed to remove many of the

perceived shortcomings of the ACA and create a more just system while keeping premiums low

and coverages available to Americans. The AHCA also tries to further stabilize the economy as a

whole by repealing the many taxes imposed onto pharmaceutical companies and insurance

providers as well as removing the personal mandate and tax penalties for being in violation of

the mandate.

This bill, labeled H.R. 1628 is sponsored by Rep. Diane Black of Tennessee and was presented to

the house on March 20th, 2017. There was a lot of heated debate in regards to this bill,

especially in regards to the pre-existing conditions clause, one that President Trump vows that

he never wanted in the bill, and many conditions that are now being considered as such.

According to many reports, rape and sexual assault would lead to an individual losing health

coverage due to the fact that they had been victimized in the past. As many things are these

days, it was discovered that these claims were for the most part false and not to mention
illegal. However in certain situations, according to Snopes a constellation of symptoms

associated with physical and emotional trauma could conceivably be used to deny health

coverage or health care.

This bill would also limit access to millions of Americans in regards to mental health treatment.

Through the ACA, Medicaid was expanded to assist low income family by providing treatment

for mental issues in manner that gave them the treatment they needed, as opposed to being

cycled through emergency rooms. With the AHCA, that Medicaid expansion would be rolled

back and that assistance will not be exist. Furthermore, the ACA used the mental health avenue

to attempt to help curb the current and ongoing opioid epidemic. Under the current bill it is

proposed that $2 million dollars be appropriated to this cause annually. For context, Gov.

Charlie Baker signed a bill last fall appropriating that same amount to assist in that undertaking

for the city of Boston alone.

Despite both of these major objections, as well as many others, H.R. 1628 passed through the

house quickly along party lines. There have been major public outcries against the passing of

the bill and many individuals are not pleased with the direction of this legislation. At the time of

this writing, it appears that this bill should die in the senate. Senators Mike Lee of Utah and

Jerry Moran of Kansas, both form the republican party, vocally and emphatically declared their

disdain for the bill. With out the support of these senators, the senate does not have the

ensured votes required to even bring the bill up for debate among the senate. The only way this

bill could be passed at this point is if it reworked and the problem areas of the bill be changed.
Even with this bill being killed and the above problems that have been stated previously, this

bill would have some merit in regards to economic stimulus and business incentive. The entire

agenda of the Trump presidency rests on 2 primary stances: economic superiority and national

security. Although many people see these as two separate areas, they are actually heavily

intertwined. In order for economic progress to take place, there must be stability and safety for

business to be transacted. However, in order to supply that security, huge sums of money must

be spent to maintain an active military, police and emergency response presence, among many

other factors.

Although the ACA called for many different taxes to be imposed on health insurance

companies, big pharma and health care providers, all of that tax income was directed to the

maintained and propagation of the health care bill. This created unfavorable tax situations for

these large companies which caused them to move many aspects of their businesses

elsewhere. For example, EMD Millipore, the American entity of Merck Industries, transferred

many aspects of logistics and product processing out of the US to their German and Swiss

counter parts. As of right now, EMD Millipore is constructing a new building right off of the 495

and Route 3 junctions in Burlington to replace and shut down there facility in Billerica. The new

facility is much smaller and many people in the Billerica office will be laid off.

The ACA also required that employers with 50 employees or more were obligated to provide

health insurance to its employees. This, coupled with the individual mandate, caused a major

strain on many small business owners and the self-employed, chiefly among the rural areas of

the United States.

Rural economies have been suffering ever since the housing bubble crash of 2008 and not much

relief has come their way. With the passing of the ACA in 2010 and the individual health care

mandate taking effect in 2012, many low income homes have been effected by high premiums

and low coverage levels while still trying to make ends meet. Many families have even forgone

the health coverage despite the mandate because the tax penalty would be less expensive and

less of a burden then carrying the minimum coverages.

Overall, the AHCA is an attempt to correct the large disparities that were caused by the Obama

era ACA. Unfortunately, this bill was presented so quickly and so little thought was put in to it,

that it makes the current law look like legislative gold, despite all of the ACAs shortcomings.

Ultimately, as the AHCA currently stands, the bill will never make it to law. As noted earlier, the

bill does not have sufficient support from enough GOP senators to even begin debate

procedures, and that support will never be given as it stands. Furthermore, with the recent

development of Senator McCain, this bill will soon have les support in the senate.

This bill also has another obstacle that may not be overcome. The House easily passed this bill

as a repeal and replace bill. The goal was to remove the issues perceived and correct them

with a bill that still provides the health care that many Americans need. The only option that is

left would be a full repeal with no replacement. However, there are not enough representatives

on either side of the aisle that would pass a full repeal of the ACA, whereas the senate GOP

would pass it very quickly. With all said and done, I firmly believe that this bill is dead and the

ACA will be the ruing law of the land for the foreseeable future.

References
FACT CHECK: Is Sexual Assault a Pre-Existing Condition Under 'Trumpcare'? (2017, May 12).
Retrieved July 19, 2017, from http://www.snopes.com/sexual-assault-pre-existing/
II, V. R. (2017, May 26). How the American Health Care Act Would Affect Mental-Health Coverage.
Retrieved July 19, 2017, from https://www.theatlantic.com/politics/archive/2017/05/how-the-
american-health-care-act-would-affect-mental-health-coverage/528291/