AHCA Vote Scrapped, Bill Withdrawn

The House of Representatives was set to vote today on the American Health Care Act (AHCA), the proposed Republican replacement for the Affordable Care Act (ACA), but they will not. Reports say, on request of President Trump, the bill has been pulled from consideration.

After a postponement, an emotional closed-door meeting of House Republicans that stretched into the night, and a day of debates on the floor, the AHCA never received vote. Many expected it to receive unanimous rejection from Democrats, and it failed to garner the necessary support from Republicans to make it through to the Senate.

Not long after noon, reports began emerging that House Speaker Paul Ryan had rushed to the White House to express concerns to President Donald Trump that the bill would fail. During a briefing in the afternoon, White House Press Secretary Sean Spicer was asked why the vote would continue if it was known that such support was lacking multiple times, and he responded that he was “not going to reveal our strategy.”

Trump himself, when asked about the scenario of a potential defeat earlier today, reportedly said, "We'll see what happens."

Debate in the House was impassioned, but all for not. Republicans repeatedly decried “collapsing” ACA exchanges, emphasizing that their intention was to remove provisions like the Medical Device Tax and increase choice and flexibility for consumers. Democrats hammered back, with Rep. Frank Pallone (D-NJ) or Rep. Richard Neal (D-MA) following every comment with a planned line, saying that they wanted to “remind” the previous Republican speaker that an estimated number of people in that Republican’s Congressional may lose their coverage under the proposed bill. The numbers were typically in the tens of thousands. The Republicans developed a similar strategy, turning around to point out the number of people in a given colleague’s state had deferred on the ACA’s individual mandate and paid the penalty tax.

Criticisms from Democrats were harsh, with John Lewis (D-GA) calling the AHCA a “disgrace” and Sander Levin (D-MI) shouting that “This is not America.” Lloyd Doggett (D-TX) called it “Not the Art of the Deal, this is the ‘Art of the Steal,’” saying it would take health care from poorer Americans, including many veterans.

Representative Mike Kelly (R-PA) tried to flip Nancy Pelosi’s criticism of the bill as a “rookie mistake” on Trump’s behalf to saying it was an antidote to a “rookie mistake,” in which Barack Obama had been the rookie. He went on to claim that 5 of the 7 western Pennsylvania counties he represents now only have access to one provider in the marketplaces.

Several Republican Representatives attempted to frame the AHCA as the first in a series of reforms. “This is the first bite of the repeal apple,” said Rep. Steve King (R-IA), saying he wished they were there to repeal the ACA outright.

“To a tee, I’ve seen my colleagues on the other side of the aisle say ‘it’s not perfect’” Rep. Thomas Reed (R-NY) said, calling the bill “a first step,” and conveying disappointment in the unanimous opposition from Democrats before calling for unity.

Immediately after, Rep. Neal followed with, “Mr. Speaker, I’d like to remind my colleague that his vote for this bill would result in 68,000 people in his district losing their coverage and care,” to a small chorus of groans from across the aisle.

Earlier this week, the Act was revised on seven points, mostly appealing to the most conservative elements of the Republican party, including the Freedom Caucus. Though the initial rollout of the bill received criticism from all sides, some of the strongest repudiations came from conservatives who thought the plan did not depart far enough from the Affordable Care Act. One change would have given states the option of imposing work requirements for Medicaid access in the cases of working-age individuals with no young children, which would ask that potential recipients prove they are employed or seeking employment; another revision would phase out ACA-associated taxes, such as the one on tanning salons, by the end of this year rather than in 2018. The late alterations were not enough to get the bill to a vote.

What follows now is unknown, with some sources speculating that the White House will attempt to distance itself from the legislation. In the briefing earlier today, Spicer said that the President had "left everything on the field" when it came to promoting the bill.

Paul Ryan opened his comments on the matter by saying, "In moving from an opposition party to a governing party, there are growing pains." He maintained that "the President gave his all" for the bill, but did express disappointment, saying that it was "a setback, no two ways about it."

A version of this story originally appears in MD Magazine.

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