Speaker of the House Paul Ryan announced that he has withdrawn from
consideration H.R. 1628, the American Health Care Act of 2017, due to the lack
of votes and to concerns from both sides of the aisle. Although ASHA did not
take an official position on the legislation, it opposed provisions within the
bill related to the block granting of Medicaid as well as the removal of the
federal requirement that all health plans include essential health benefits
(EHBs). EHBs include coverage of habilitative and rehabilitative services and
devices. ASHA's federal team has been meeting with Congressional staff to
express the Association's concerns with those provisions.
At this point, it is unclear whether or not the House will consider
another Affordable Care Act (ACA) repeal bill this session. However, in
announcing the decision to repeal the bill, Speaker Ryan indicated that the
House would move on to other Trump Administration policies, such as tax reform.
The possibility remains that Senate leaders may work to develop a plan to
repeal and replace the ACA, but any legislation in the Senate would need 60
votes to pass. In addition, a bill as such would have trouble passing in the
The withdrawal of the bill in the House does not mean that the Trump
Administration cannot move forward with repealing the ACA through regulatory
and executive action. On Inauguration Day, President Trump signed an executive
order that set the groundwork for federal agencies to take immediate regulatory
steps to dismantle parts of the ACA. The executive order allows the U.S.
Department of Health and Human Services (HHS)—and other agencies with authority
to implement the ACA—the flexibility to "waive, defer, grant exemptions from,
or delay the implementation of any provision or requirement" of the ACA to the
maximum extent permitted by law.
Under this executive order, HHS Secretary Tom Price has the authority
to authorize Medicaid waiver applications. This would allow states to begin revamping
their Medicaid programs, which could include such changes as allowing work
requirements for able-bodied adults and requiring contributions to health
savings accounts. Secretary Price also has the authority to review current ACA
regulations, which would include review and revisions to regulations that outline
ASHA will continue to work with Congress as well
as HHS on these important issues. For additional information on Congressional
activities, contact Ingrida Lusis, ASHA's director of federal and political advocacy,
at firstname.lastname@example.org. For regulatory
advocacy information, contact Tim Nanof, ASHA's director of health care policy
and advocacy, at email@example.com.