Amended AHCA Is Not Repeal: Federal Gov’t Will Still Control Health Care

By Twila Brase | May 2, 2017 | 4:23pm EDT
Speaker Paul Ryan touts the GOP's health care reform bill the American Health Care Act. (CNN Screenshot)

The biggest buzz in health care is the possibility of the passage of the amended American Health Care Act (AHCA), now that more conservatives and some moderates are supporting the latest changes.

There’s still one major flaw in the amended bill—it’s not repeal.

The fact is, regardless of the support the amended bill has garnered, this is not repeal. The federal government is still in control of health care, and states must ask permission for a variety of items, including waivers regarding pricing for state insurance premiums. Health plans will remain in control as well. AHCA does not return health freedom to Americans.

One “catch” regarding the state waivers is that the state legislature must decide to submit the waiver application. Exemption from Obamacare mandates is not automatic, and many states may not choose to do the politically difficult work of ending these benefits, despite their costs. In addition, although the application is approved for up to a period of 10 years if the state is not notified by the Secretary of Health and Human Services (HHS) within 60 days, Dr. Tom Price will not always serve as the Secretary of HHS, and the next secretary may be much less willing to grant state waivers of Obamacare requirements.

Beyond the federal controls still in place, if the amended AHCA passes, it’s likely that Republicans will “own” everything remaining about Obamacare, and as soon as Republicans claim credit for “repeal and replace,” the public will view everything that happens as a result of not actually repealing the law as the fault of Republicans.

The amended AHCA doesn’t expand competition. It is essentially Obamacare with some permissive aspects—the totality of Obamacare minus most of its taxes, minus the individual and employer mandates, plus some potential freedom for states, but with it, mandates, penalties and billions of dollars of subsidies, without any guarantee of lower costs, greater choices or broader networks.

Why waste time trying to resurrect AHCA or pass another Obamacare replacement bill? As I suggested in a recent op-ed with The Washington Times on cost-sharing reduction subsidies, “Americans want Obamacare repealed.”

Twila Brase is president and co-founder of Citizens’ Council for Health Freedom (CCHF,, a Minnesota-based national organization dedicated to preserving patient-centered health care and protecting patient and privacy rights.


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