The Zombie Trumpcare (AHCA) Cheat Sheet

On May 4, the Republican-controlled House of Representatives voted 217-213 (1 not voting) to pass an amended version of the American Health Care Act, moving Congress a step closer toward repeal and replacement of much of President Barack Obama’s Affordable Care Act.

Read four perspectives on the AHCA in this week’s edition of Health Wonk Review.

Republicans managed to make the vote happen just a day before the House takes a one-week recess and in spite of significant resistance to the legislation. After fierce lobbying, leadership whipped enough reluctant GOP House members to vote Yes, though 20 Republicans stood firm in their opposition to the legislation.

Who opposed the AHCA

Those 20 Republicans weren’t alone in opposition to the bill. A number of high-profile organizations opposed the bill.

Basically every major health grp -docs, hospitals, patient advocates -oppose GOP bill up for vote tmrw https://t.co/mnz4Dw2SzN via @politico

— Jason Millman (@JasonMillman) May 3, 2017

Some health insurance industry leaders also opposed the AHCA:

Breaking the industry's silence, Blue Shield CEO opposes GOP health bill #AHCA #Obamacare https://t.co/0jW7OiO0PV @Repeal_Replace

— Chad Terhune (@chadterhune) May 4, 2017

In the days leading up to the vote, approximately two dozen Republicans had signaled that they were possible No votes on the legislation. And even inside the White House, administration officials said no one “really loves the legislation.”

Trump doesn't seem very psyched about the Obamacare repeal bill. https://t.co/A0zOUwN5EN pic.twitter.com/9Rezj7RRXF

— Jason Millman (@JasonMillman) May 4, 2017

Why opponents reviled the AHCA

1. The bill eliminates protections for those with pre-existing conditions. (Slate)
2. It makes essential health benefits optional. (Vox)
3. The bill would slash $880 million from Medicaid (Politico) and punishes the working poor. (Vox)
4. Millions are projected to lose coverage under the bill. (New York Times)
5. The AHCA still includes an exemption for members of Congress. (Vox)
6. The bill would eliminate Obamacare’s community rating provision. (Wendell Potter)
7. The high-risk pools in the AHCA won’t be funded adequately to actually cover folks with pre-existing conditions.
8. Republicans rushed to pass the bill. (New York Times)
9. The GOP is voted on the bill even though it hasn’t been scored yet by the Congressional Budget office. (Vox)
10. A brand new reason – that thanks to a little-known provision of the AHCA, the people who get health insurance through their employers could stand to lose ACA protections that limit out-of-pocket costs for catastrophic illnesses. (Wall Street Journal)
11. Americans would lose coverage in all 435 Congressional districts.
12. The bill looks like an attack on women’s health – including defunding Planned Parenthood.

Who stands to lose coverage?

1. People with pre-existing conditions. Find out how many in YOUR Congressional district. (acasignups.net)
2. Everyone? Everywhere? (Families USA)

What happens next?

The legislation will move next to the Senate, but action won’t happen there immediately since the Senate must wait for Congressional Budget Office scoring of the legislation before a rewrite happens.

How you can weigh in

Want to react to the vote of your member of Congress? Here are their phone numbers, Twitter and Facebook accounts.

Steve Anderson is editor and content manager for healthinsurance.org, where he’s been writing about health insurance and health reform since 2008. He’s been fortunate to have worked with a talented team of health policy writers.