Members of Congress spent the last two weeks at home in their districts hearing once again from their constituents that Republicans’ repeated attempts to repeal the Affordable Care Act and gut Medicaid is not what they want. Facing continued public pressure to answer tough questions about how constituents will be able to access and afford life-saving care, some members, like Florida Congressman Brian Mast, went so far as to offer continued support for retaining the ACA’s provisions that prohibit insurers from charging people with pre-existing conditions more for their coverage. Apparently, Republican leaders in the House of Representatives weren’t listening.

Last night, an amendment to the American Health Care Act (AHCA) surfaced as an alleged deal to bridge the gap between the party’s more moderate members, who are concerned about weakening benefits and striping coverage from their constituents, and members of the Freedom Caucus, whose primary concern is reducing the federal deficit even if that means increasing the number of uninsured people by 24 million.

We don’t have many details about this amendment beyond this outline, but here’s what we can conclude:

  1. It keeps intact the cuts to Medicaid totaling $880 billion, despite vocal opposition from stakeholders like hospitals, providers and state policymakers.
  2. It allows states to get rid of the essential health benefits, which would take us back to the days of plans without coverage for maternity care, substance use disorders or mental health services. This means, for example, that women will have to pay more for coverage that actually meets their health care needs.  
  3. It gives states the option to restore the pre-ACA status quo and charge people with pre-existing more for their coverage if the state establishes a high-risk pool or participates in the federal high-risk pool under the AHCA. This would dramatically decrease the affordability of plans for people with pre-existing conditions and would lead to premium increases upwards of tens of thousands of dollars for coverage that is unlikely to meet their health care needs.

Protecting people with pre-existing conditions is undoubtedly one of the most popular provisions of the ACA, and allowing states to take away these key protections only makes this bad bill worse. The Trump Administration and Republican leadership have proven once again that their only interest is to pass a bill for a political win so that they can move on to the rest of their agenda.

Let’s keep reminding them that this bill is terrible for consumers, and it’s time to move forward in a bipartisan way to improve the ACA, protect and strengthen Medicaid, and advance a health reform agenda that addresses the real needs of their constituents!