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After the AHCA: Is There Room for Compromise on Health Care?

U.S. Capitol building
Photo by Kevin McCoy. https://commons.wikimedia.org/wiki/United_States_Congress#/media/File:Uscapitolindaylight.jpg

The American Health Care Act appears to be dead, barring a pre-Easter resurrection. But is there an underlying consensus on elements of future health care legislation that could make a future bill palatable to a broad coalition in Congress?

According to Robert Field, PhD, JD, professor in Drexel’s Dornsife School of Public Health and the Kline School of Law, a lot of fundamental disagreement remains.

“Republican efforts to revive the AHCA from the dead will encounter pushback from Democrats and moderate Republicans who want to maintain coverage for as many people as possible,” Field said. “GOP leaders are caught between a rock and a hard place. To please the conservative wing of the party, they will have to cut coverage even more, which will make the bill less palatable to moderates.”

But outside of the Republican conservative wing, there actually is consensus among many in Congress on several key points. The main one is to leave the Medicaid expansion alone.

“Democrats and moderate Republicans want to keep the Medicaid expansion in essentially its current form,” Field said.

That point was hammered home last week when the senate of Kansas, a long-held Republican state, sent a bill authorizing the expansion of Medicaid in the state for up to 150,000 people to its governor, although he subsequently vetoed it.

Medicaid expansion is not the only potential point of agreement between Democrats and moderate Republicans, Field thinks.

“Both would like to see a well-functioning market for individual insurance with subsidies for those most in need,” he said. “And both would like to focus on the needs of older Americans who are not yet old enough for Medicare.”

Achieving all of that could be done within the current framework of the Affordable Care Act.

“I don’t think conservatives would sign on to any of these goals, but there seem to be enough Democrats and moderate Republicans to push for workable compromises that build on the current ACA while smoothing out its bumps,” Field said.

“But,” he added, “That can only occur only if they have the chance to work together in the current highly partisan environment.”

Media interested in speaking to Field should contact Frank Otto at 215.571.4244 or fmo26@drexel.edu.

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