The Great Healthcare Divide: Unraveling The Republican Exception

In 2017, Republicans attempted to exempt themselves from their own health care proposal, the American Health Care Act (AHCA). The AHCA was intended to replace the Affordable Care Act (Obamacare). The bill included an amendment that would allow states to waive certain Obamacare requirements, including coverage for pre-existing conditions, maternity care, and mental health care. However, members of Congress and their staff, who were required to buy insurance through the marketplace like every other Obamacare enrollee, would not be affected by these changes. This exemption was included to ease the passage of the bill, as it would allow the Senate to pass the legislation with a simple majority. After public backlash, Representative Tom MacArthur, author of the amendment, said he would close the loophole in a separate piece of legislation. Representative Martha McSally of Arizona also proposed a stand-alone bill to strike the exemption, which passed unanimously.

Republicans initially included an amendment to exempt themselves from the American Health Care Act

In 2017, Republicans initially included an amendment to exempt themselves from the American Health Care Act (AHCA). The AHCA was a bill in the 115th United States Congress that would have partially repealed the Affordable Care Act (ACA), also known as Obamacare. The AHCA was passed by the United States House of Representatives but not by the United States Senate.

The amendment, introduced by Representative Tom MacArthur (R-NJ), would have allowed states to waive Obamacare's ban on pre-existing conditions. This meant that insurers could charge sick people higher premiums than healthy people. However, the amendment included an exemption for members of Congress and their staff, who would have been guaranteed to keep the Obamacare regulations.

The exemption for Congress and their staff was included for procedural reasons to ease the passage of the bill. Republicans were seeking to pass the AHCA as a reconciliation bill, which would allow the Senate to pass the legislation with a simple majority. However, due to specific rules about what can be included in a reconciliation bill, the exemption for Congress was removed through a separate bill introduced by Representative Martha McSally (R-AZ). This bill passed unanimously, meaning that Congress will live by the same health care rules as other Americans.

The exemption was removed via a separate bill by Rep. Martha McSally

In 2017, the American Health Care Act (AHCA) was passed by the House. The bill, which aimed to replace the Affordable Care Act (Obamacare), included an amendment that would allow states to waive out of Obamacare's ban on preexisting conditions. This meant that insurers could charge sick people higher premiums than healthy people. However, the amendment included an exemption for members of Congress and their staff, allowing them to keep the Obamacare regulations.

This exemption was criticised by Democrats, who argued that it showed that the bill's supporters did not want to be subject to it. In response, Representative Tom MacArthur, who authored the amendment, said he would close the loophole. However, this fix would be included in separate legislation and not in the AHCA itself.

The separate bill offered by Representative Martha McSally, a Republican from Arizona, eliminated the congressional exemption from the House health plan. Known as H.R. 2192, the bill passed unanimously (429-0) in the House on May 4, 2017. In her speech on the House floor, McSally emphasised that "any law we pass [that] applies to our constituents must also apply equally to members of Congress" and that "individuals who are stewards of public trust must abide by the rules that they make".

With the passage of McSally's bill, Congress will be subject to the same healthcare rules as other Americans.

The exemption was due to arcane Senate procedural rules

The American Health Care Act (AHCA) was a Republican-backed bill, and an attempt to replace the Affordable Care Act (Obamacare). The AHCA included an amendment that would allow states to waive certain Obamacare requirements, including coverage for pre-existing conditions, maternity care, and mental health care.

The AHCA, passed in the House on May 4, 2017, included an amendment by New Jersey Rep. Tom MacArthur that specifically exempted members of Congress and their staff from the effects of such state waivers. This meant that members of Congress and their staff would be exempt from losing some popular provisions of the health coverage available under Obamacare.

However, the reason for this exemption was not to protect the insurance of members of Congress. Instead, it was a parliamentary tactic to assure passage of the bill. It was due to arcane Senate procedural rules within the budget reconciliation process.

Reconciliation rules dictate that House committees drafting a bill cannot make changes that are under the jurisdiction of other committees. Republicans likely feared that a Senate parliamentarian might rule that a proposed insurance change for members of Congress would fall under the jurisdiction of the Homeland Security and Governmental Affairs Committee. Such a ruling could jeopardize the bill's reconciliation status.

To address this, Rep. Martha McSally of Arizona proposed a stand-alone bill to strike the exemption of Congress from state waiver provisions should the AHCA be enacted into law. The bill passed on May 4 by a 429-0 vote. McSally blamed very arcane Senate procedural rules for the fact that the MacArthur amendment did not apply to members of Congress in the first place.

Republicans wanted to keep popular Obamacare provisions for themselves

In 2017, House Republicans included a provision in their latest health care plan that would exempt members of Congress and their staff from the plan's changes. This meant that lawmakers and their aides would not be affected by the plan's waiver that allowed states to opt out of Obamacare's ban on pre-existing conditions, which could result in higher premiums for sick people.

The Republican amendment, introduced by Rep. Tom MacArthur, would allow states to waive out of key Obamacare protections like the ban on pre-existing conditions, the requirement to cover maternity care, and mental health services. However, members of Congress and their staff would be guaranteed to keep these Obamacare regulations.

This exemption was included for arcane budget reasons and to assure passage of the bill, rather than the personal benefit of Republican lawmakers. Republicans were attempting to speed the health care repeal through Congress using a legislative process called reconciliation to limit debate on the Senate floor and shield it from minority opposition.

However, this exemption was heavily criticised and sparked accusations of hypocrisy. In response, Rep. Tom MacArthur released a statement saying he would close this loophole, although it would be contained in separate legislation and not offered as part of the American Health Care Act.

Ultimately, a separate bill offered by Rep. Martha McSally eliminated the congressional exemption from the House health plan. Her bill was approved by the House with a vote of 429-0, demonstrating bipartisan agreement that a health care law passed by Congress should apply equally to members of Congress.

The bill would have allowed states to waive out of Obamacare's ban on pre-existing conditions

The American Health Care Act (AHCA) was a bill introduced by House Republicans in 2017 to replace the Affordable Care Act (ACA), also known as Obamacare. The bill included an amendment that would allow states to waive out of Obamacare's ban on pre-existing conditions. This meant that insurers could charge sick people higher premiums than healthy people.

The amendment was authored by Representative Tom MacArthur, a Republican from New Jersey. MacArthur's amendment also specified that members of Congress and their staff would be exempt from the effects of such state waivers. In other words, they would be allowed to keep Obamacare's regulations regarding pre-existing conditions. This exemption was included because members of Congress and their staff are required to purchase coverage through the health law's marketplace, just like Obamacare enrollees.

The inclusion of this exemption led to accusations of hypocrisy from Democrats. In response, Representative Martha McSally, a Republican from Arizona, proposed a separate bill to strike the exemption of Congress from state waiver provisions if the AHCA were to become law. This bill passed unanimously, meaning that Congress would have to live by the same health care rules as other Americans.

The AHCA passed the House by a vote of 217 to 213 and moved to the Senate for a vote. However, it is unclear if the bill ever became law, as there were reports of ongoing debates and amendments.

The debate around the AHCA highlights the complexities and challenges of health care reform in the United States. While the bill aimed to provide states with more flexibility in health care regulations, it also raised concerns about protecting vulnerable individuals with pre-existing conditions.

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