Why the Obamacare repeal is being held up — at least for now

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John O'Connor
John O'Connor

There was a celebration at the White House earlier this month after the House narrowly voted to replace the nation's health law. Turns out the party might have been a bit premature.

More than two weeks later, the House has still not advanced the American Health Care Act to the Senate. And it's beginning to become clear why.

It turns out that some parts of the hastily crafted legislation may need some additional fine-tuning. Or possibly, a complete overhaul.

Remember, the Obamacare repeal (which, let's face it, is exactly what this is) went through the House faster than grass through a goose. As such, it did not contain a Congressional Budget Office estimate of its fiscal impact. Once those numbers are tallied and released, some of the costing assumptions might not stand. Depending on how many adjustments are required to make things copacetic, the House might even have to vote again.

That health reform legislation might not survive a second House vote would not necessarily come as bad news for many post-acute operators. That's because the bill now in play would slash the sector's primary revenue source – Medicaid – by almost $840 billion over the next decade. Moreover, the replacement allows Essential Health Benefits provisions to be waived, which could eviscerate rehab-care funding. Small wonder several long-term care groups are already lobbying the Senate to just say no.

The revelation that the House measure is still in the House sparked predictable partisan responses. Democrats expressed outrage at the holdup, while Republicans insisted they were merely moving with appropriate caution.

So what should operators be paying attention to in the days (or perhaps weeks) to come? The first is how the CBO prices the costs, especially if the federal bean counters determine that prior estimates were way too low. The second is how the House leadership responds.

Those two developments will go a long way toward determining what the Senate gets to work with – and whether a new health care law might be enacted any time soon.

Stay tuned.

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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