Republicans Will Own Whatever Happens to the ACA and Health Care Reform | Health Care Reform | JAMA Forum Archive | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
JAMA Forum Archive, 2012-2019: Health policy commentary from leaders in the field
JAMA Forum

Republicans Will Own Whatever Happens to the ACA and Health Care Reform

As has become clear, “Repeal and Replace” of the Affordable Care Act (ACA), a mantra that provided such a unifying theme for Republicans when Democrats controlled the White House, has been much harder than Republicans expected when they achieved “full control” of the government. Republicans were barely able to pass a health care bill in the House despite their substantial majority over Democrats (240-194) and the Senate fell short of passing the so-called “skinny” repeal bill, HR 1628, which repealed only a limited portion of the ACA.

Because House Republicans had worked on a broad agenda for change in 2016 under the leadership of Paul Ryan, the challenge in the House was somewhat surprising—perhaps caused by the understanding that an affirmative vote for repeal was no longer merely symbolic but might become law. Moderates, who previously had supported their leadership, were uneasy by the Congressional Budget Office projection that up to 23 million more people would be uninsured within a decade as a result of the House legislation. Conservatives wanted even more of the ACA repealed than was possible with the constraints in the Senate, which was focusing on budget-related legislation that could be passed with a simple majority.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words