Voting on the AHCA

by Ryan Kelly –

Voting was set to take place today by the US House of Representatives on the new healthcare legislation.  But, due to the moderate and libertarian pulls of the GOP not coming to a consensus in time, the vote has been postponed to a later date.

Why is the vote delayed?

As I have been saying, we need to pump the breaks a bit on the specifics of the bill.  There are still details concerning to those that want to reduce the size and scope of government’s involvement in healthcare, as well as those…mainly from Medicaid-expansion states…that want to ensure the guarantees promised to their states for healthcare reform.  Of course, caught in the middle are the healthcare professionals searching for solutions to their many issues.

I expect many of these concerns will be satisfied in the coming days, and the vote in the House may take place next week (good for me, because I’ll be in DC and may be able to see the deliberation and vote in-person).

Even if House approves, not so fast

It is largely assumed that the House will eventually pass the bill and move it to the Senate. This is where the real fun starts, though.  The Senate can only pass this through budget reconciliation by 2 votes.  With the extremes of the party present in the Senate, there will be fierce negotiation and deal-making.

It’s in the Senate where the MRHA will align with other parties to ensure that rural is supported in the final markups.  All we need is to ensure that rural is considered with payment models, particularly the enhanced Medicaid requirement for the legacy fee-for-service clinics such as RHCs.

UPDATE

Since the time of the publish of this post, the House of Representatives withdrew the AHCA from the docket due to a lack of votes needed to pass.

My analysis of the above remains true.  I believe it’s a good thing that our legislators are going to take more time to build a more complete bill that addresses the many complexities and needs of our healthcare industry.  Although the first bill had many good components, it only addressed a fraction of the needs of healthcare professionals.  I anticipate that in the coming weeks or months, conversations with stakeholders like the MRHA / NRHA / NARHC will allow for a better bill which will pass the House easily.  And, possibly will already meet the needs of the Senate and will pass there too.

Time will tell.  For now, we’ll keep up the hard work to support rural health in all language both direct and indirect in the coming legislation.