As President Trump reaches his hundredth day in office, his goal of repealing and replacing the Affordable Care Act (ACA) has stumbled once again, with Speaker Paul Ryan and House Republican leadership unable to find the necessary votes to pass the American Health Care Act (AHCA) and move debate to the Senate.
As we wrote yesterday, despite newfound support from the House Freedom Caucus, moderate House Republicans are still opposed to the AHCA, in part due to the inclusion of an amendment that would allow states to opt out of programs that provide Essential Health Benefits and maintain Community Rating Provisions. The ANA continues to oppose the AHCA due to serious concerns that the bill would violate key organizational principles and harm both nurses and patients alike.
Resolved to continue
House and Senate leadership were able to temporarily avert a government shutdown, passing a one-week spending measure on Friday that maintains current spending levels and gives lawmakers additional time to negotiate a longer-term package that will fund the government through September 30th. House Democratic Leader Nancy Pelosi had previously stated that her caucus would not vote for such an agreement if Speaker Ryan and the White House held a vote on the AHCA this week.
100 Days In
While the President has signed a number of executive orders and legislation in his first 100 days that repeal actions taken toward the end of President Obama’s second term, the White House has been consistently stymied by a Congress that seems unwilling to embrace its broader legislative agenda, despite Republican control of both chambers.
The President’s biggest victory is arguably the confirmation of Supreme Court Justice Neil Gorsuch, who was approved by the Senate earlier this month to fill the seat that was vacated following the death of Justice Antonin Scalia. Despite a limited number of achievements, polling consistently shows that the President’s conservative supporters continue to approve of his job performance and are optimistic he’ll be able to fulfill his campaign promises.
Following their failure to hold a vote on the misguided American Health Care Act (AHCA), congressional Republicans now head into a two-week recess with more questions than answers. Despite continuing negotiations with the House Freedom Caucus, the basic dynamic hasn’t changed: for every vote Republicans pick up from the conservative wing of their House caucus, they lose votes from their moderate wing. And the reason for their continued failure hasn’t changed: the AHCA is a fundamentally flawed bill that would cause millions to lose health coverage by cutting Medicaid and taking away essential benefits.
Even worse, proposed concessions made by Vice President Mike Pence could undermine protections for people with pre-existing conditions, and lead to states allowing insurance companies to charge sick people more for coverage than healthier individuals, to name just two possible outcomes.
Republicans’ persistence and the AHCA’s shortcomings underline the importance of the next two weeks. As is customary for recess periods, Members of Congress from across the country will be holding town halls to hear directly from their constituents. Now more than ever, it’s imperative that lawmakers understand that a majority of voters are opposed to the AHCA and similar efforts to make Americans less healthy.
President Donald Trump released his budget plan for fiscal year 2018 yesterday morning, presenting Congress with a blueprint for how he believes they should fund the federal government. Unfortunately the President’s proposed budget will weaken the nation’s health care system and jeopardize the scientific research that’s necessary to keep Americans healthy. The ANA opposes the President’s budget, and urges Congress to reject it in favor of a plan that doesn’t compromise health care in favor of political and partisan posturing.
The President’s budget, which represents his priorities but does not carry the power of the appropriations process controlled by Congress, makes a number of ill-considered cuts when it comes to the American health care system, including:
A $403 million reduction in funding for health professions and nursing workforce programs;
A $5.8 billion cut from the National Institutes of Health (NIH) budget, constituting a 22% reduction in funding for scientific research to find medical cures, and;
A decision to fold the Agency for Healthcare Research and Quality (ARHQ) into the NIH. Currently, AHRQ is the only federal agency mandated to conduct health services research.
“As the demand for high-quality health care intensifies, Congress must firmly invest in the nation’s largest health-care workforce, registered nurses. Decreasing funding by $403 million will significantly cripple efforts to effectively recruit, train and educate nurses for practice in rural and medically underserved communities,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN.
The ANA is instead urging Congress to provide $244 million to fund nursing workforce development programs, $160 million for the National Institute of Nursing Research, $380 million for the National Health Service Corps, and to restore AHRQ’s funding to at least $364 million in FY 2018.
Despite the organization’s concerns over these misguided cuts, the ANA does support the President’s call for a $500 million increase to expand opioid misuse prevention and treatment efforts.