March 22, 2023
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National Recap: Republican health care bill falls flat

In a devastating blow to President Donald Trump’s plan to overhaul the Affordable Care Act, the Republican Party’s proposed replacement bill has failed.

The GOP had been working for the past few weeks on the American Health Care Act, but tensions between centrist Republicans and far-right conservatives splintered support for the legislation, ultimately pushing Speaker of the House Paul Ryan (R-Wis.) and Trump to pull the bill March 24 because it was short by 1015 votes.

What Ryan and the president discovered were the difficulties in appeasing both the far-right and the centrist-right on health care to garner enough votes for the bill to pass. When the bill was first presented, far-right conservatives of the Freedom Caucus were dissatisfied, leading Ryan to tweak parts of the bill to please them. Yet some of these new changes included repealing benefits that guaranteed health insurance plans for people in the U.S. Even still, these changes were not enough to win the support of members of the Freedom Caucus, who wanted a bill that more aggressively dismantled the ACA.

If passed, the AHCA would have repealed tax penalties for people without health insurance, cut federal funding to Planned Parenthood for one year and rolled back federal standards on insurance. The AHCA also would have resulted in significant cuts to Medicaid, a facet of the bill that influenced many moderate Republicans to oppose the bill. Under the ACA, Medicaid expanded to cover 11 million low-income adults in the U.S. while simultaneously guaranteeing that the federal government would cover their costs.

An analysis from the Congressional Budget Office also led to decreased support from House Republicans. The office predicted that the ACHA would have left 24 million people without health insurance and cut spending on Medicaid by $839 billion. The CBO also predicted that the ACHA would have reduced the number of those on Medicaid by 14 million people over the next decade. The cost of insurance for older people also would have seen a sharp increase.

The final nail in the ACHA’s coffin came when Republican leaders announced they would eliminate federal standards for minimum benefits that must be provided by health insurance. Some of these benefits include emergency services, maternity care, mentalhealth services and substanceabuse treatment.

Following the bill’s defeat, Ryan said the ACA would remain the “law of the land until it’s replaced.” Trump blamed the failure of the bill on Democrats and even on the Freedom Caucus via Twitter. And in a phone interview with The New York Times, Trump said, “Obamacare unfortunately will explode. It’s going to have a very bad year.” During the administration’s first news conference since the bill’s failure, White House Press Secretary Sean Spicer said the president’s abandoning of the bill equated to walking away from a bad deal. Reports have recently surfaced that the GOP has restarted efforts to repeal the ACA.

Celisa Calacal can be reached at or via Twitter: @celisa_mia