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The repeal and replacement of the ACA: Where is it at?

On May 4, Congress approved legislation to repeal and replace major parts of the Affordable Care Act (ACA). The latest version of the American Health Care Act (AHCA) rolls back the expansion of Medicaid and allows states to opt out of covering patients with pre-existing conditions. The bill now faces uncertainty in the Senate.

The proposed AHCA would end Medicaid’s status as an open-ended entitlement. The bill will also repeal taxes on the super rich, insurers and drug companies. Furthermore, under the new bill, states could adjust coverage for essential medical services such as maternity and emergency care. The latest AHCA seems to be a patchwork of provisions.

The bill will most likely be amended by the various Republican factions within the Senate. In addition, the Senate Republicans have been working on their own version of the health care bill, which will consider the ideas already in the House bill. Once the Senate passes its new or updated version of the AHCA, that bill will return to the House for another vote.

However, the biggest unanswered question with any replacement of the ACA is that no one can calculate how many people would be covered under a new health care bill. By May 22 the Congressional Budget Office (CBO) will release its report on the cost and potential coverage of the new AHCA. The analysis of this bill will be complicated by the fact that it leaves a lot to the states. It will be up to the Senate Republicans to consider the implications of the upcoming CBO report.