What AHCA’s failure means for physicians

While Republicans have pulled the American Health Care Act (AHCA) after failing to gather enough support for its passage, physicians can expect little to change-for now. But experts say watching what the Trump Administration does next will determine how healthcare might be affected.

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“President Trump has said he will let it die of its own weight, but it appears he might be willing to help it along to its demise,” says Julius Hobson Jr., a healthcare lobbyist with the Washington D.C. office of national law firm Polsinelli. Hobson has more than 40 years of experience working in and with the federal government, and is a former lobbyist for the American Medical Association.

Julius Hobson Jr.

But any administrative actions that Trump or Secretary of Health and Human Services Tom Price take to hobble the ACA can be challenged by individuals or class action suits to force them to implement the law, says Hobson. The Republican-controlled Congress may try to take actions in the appropriations bill that funds government operations, but that can be filibustered in the Senate, limiting what actions may be possible.

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The survival of the ACA may not be determined until this fall, when private insurers start making decisions whether to continue selling insurance in the various state exchanges. “Doctors ought to be concerned about patients who may end up with no insurance but are not poor enough for Medicaid if the ACA goes away,” says Hobson. “Will the ACA collapse on its own? No. The only way a law collapses is if someone helps it along. It remains to be seen whether the Trump Administration will attempt to do that.”

Next: The future of healthcare reform remains cloudy

The future of healthcare reform remains cloudy, with conflicting messages coming from the White House. President Trump indicated after the bill was pulled Friday that he was moving on, but tweeted over the weekend, “ObamaCare will explode and we will all get together and piece together a great healthcare plan for the people. Do not worry!”

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And Rep. Phil Roe, MD, (R-Tennessee), co-chair of the House GOP Doctors Caucus, issued a statement that read in part: “Our work to protect patients from the failures of Obamacare will continue. With one-third of the counties in the first district [of Tennessee] left with no options for healthcare coverage in 2018 under Obamacare, and with double-digit premium increases year after year, this is the beginning of the debate, not the end.”

Hobson says physicians can probably expect to hear more about healthcare reform in the coming months. “The funny thing about this process is that it’s not over until the fat lady sings, and in politics, there is no fat lady. The withdrawal of the bill is more of a setback than a failure. It is up to Speaker [Paul] Ryan and the administration as to whether or not they want to pursue something like the AHCA again.”