One year ago today, after just seven hours of debate, the House Republicans repealed the Affordable Care Act, promising to direct key committees to draw up their own legislation to replace the Democratic blueprint and find a way to restore health care coverage to 32 million Americans. “This majority is dedicated to growth for the American people. Repealing last year’s health-care law is a critical step,” Rep. Eric Cantor (R-VA) said in closing remarks, after the measure passed in a vote of 245 to 189. The next step, replacing the law, begins “an honest debate about a better way forward,” Cantor promised.
But that debate never came. Instead, Republicans held numerous hearings to water down various parts of the law, from eliminating the already defunct long-term care program to questioning regulations that aim to control insurer profits (by requiring companies to spend 80 to 85 percent of premium dollars providing health care services). The repeal legislation stalled in the Senate, but had it passed, millions of young adults would find themselves without health insurance, seniors would continue to fall into the Medicare prescription doughnut hole, small businesses would lose tax credits and grants for providing health insurance coverage, and insurers could still rescind coverage or deny it on the basis of pre-existing conditions. The repeal bill also increased the deficit by billions of dollars and allowed health care spending to rise at an unsustainable rate.
Before the final vote, the Democrats unsuccessfully offered a motion to recommit that would have prevented the law from being repealed unless a majority of members gave up their own government-sponsored health coverage, which, like the ACA, can be purchased through a government-regulated exchange of private health insurers who cannot discriminate against sicker people. At the time of the vote, only nine Republicans said that they would opt out of the taxpayer-subsidized Federal Employee Health Benefits Plan (FEHBP). The overwhelming majority voted to significantly limit access to health care for millions of Americans, while continuing to receive their own well-regulated government financed benefits.
In the year since the vote, however, the health care industry and the reddest of red states have made peace with the law and have begun to implement various parts of the measure. Health insurers, for instance, who were once the strongest political opponents of the reform, are huddling with Republican governors to plot strategy for building the exchanges. The Chamber of Commerce is no longer calling for outright repeal and 28 states and the District of Columbia “are on their way toward establishing their own Affordable Insurance Exchange,” having received three rounds of grants from the federal government to set up the new regulated marketplaces where small businesses and individuals will be able to compare and shop for comprehensive insurance beginning in 2014. That, to borrow Cantor’s words, seems to be the “better way forward.”