Three out of Greater Cincinnati's four House representatives voted Thursday in favor of the American Health Care Act, Republicans' years-in-the-making replacement for former President Barack Obama's signature Affordable Care Act. (You might know the latter better as Obamacare.)
Although the legislation has attracted criticism from groups such as the American Medical Association and American Cancer Association, House Republicans celebrated its passage as a legislative landmark achievement for the fledgling Trump administration.
Meanwhile, local organizations such as the Health Collaborative are trying to figure out exactly what the AHCA might mean for their patients. Like the Affordable Care Act, it's a complex and highly technical piece of legislation full of cross-references and provisions that could change radically between this passage and any final implementation -- but for now, said Rebecca Cochran, the people most affected will likely be those on Medicaid.
"The biggest changes are those to Medicaid, which is a large federal program that aids vulnerable populations.: Those who are elderly, poor, disabled. (The AHCA will be) virtually rolling back the Medicaid expansion that was the hallmark of the Affordable Care Act."
Here's what the men representing our area had to say about the bill's passage.
Rep. Steve Chabot (R-Cincinnati)
Chabot, who represents Cincinnati proper alongside Rep. Brad Wenstrup, voted to support the bill. He said in a statement that he believed the Affordable Care Act had entered a "death spiral" that prevented many Americans from accessing the care it was meant to provide.
"The House bill takes the power over health care decisions out of the hands of the bureaucrats in Washington and returns it to doctors and patients," he said. "Additionally, in the place of one-size-fits-all federal mandates, it gives states the ability, if they choose, to craft health care solutions that work better for local patients."
Rep. Brad Wenstrup (R-Cincinnati)
Wenstrup, who worked as a podiatrist and Army surgeon before entering politics, brought up his background in his own statement about his "yes" vote on the AHCA.
"As a doctor, I believe it would be malpractice to allow Obamacare to continue to crumble," he wrote. "It's time to get the ball rolling and send this bill to Senate."
WCPO reached out to Wenstrup for a comment on assertions (made by news outlets such as New York Magazine) that the AHCA would negatively impact Americans with pre-existing health conditions -- including such ‘conditions' as having been raped or abused, experiencing postpartum depression or having given birth via Caesarean section.
"Providing care for victims of violence, particularly those who have suffered sexual violence, must always be a priority," he said. "This bill treats all pre-existing conditions equally and makes sure states can only obtain a waiver if they have a federal or state high-risk pool in place to ensure patients with pre-existing conditions are able to get affordable coverage."
That's true, but Politifact wrote that it's less rosy a prospect in practice. Although an amendment to the AHCA specifies that insurers must provide some form of health coverage to people with pre-existing conditions, it does not place limits on the rates they may charge those people. It would therefore still be possible for people with pre-existing conditions to be priced out of being able to afford health coverage.
High-risk pools are meant to provide insurance for the very sick while keeping premiums low for their healthier counterparts, CNN reported, but are more expensive for the people they insure and can discourage enrollment via high costs and strict qualification guidelines.
"The history of high-risk pools demonstrates that Americans with pre-existing conditions will be stuck in second-class health care coverage -- if they are able to obtain coverage at all," Andrew W. Gurman, president of the American Medical Association, told CNN.
Rep. Warren Davidson (R-Troy)
"Reforms to Medicaid, work requirements for able-bodied adults, and defunding Planned Parenthood are no small victories," Davidson wrote in a statement. "Americans are actively suffering under Obamacare and this bill brings much-needed and long-promised relief."
Davidson had a more terse response to questions about the possibility of abuse victims being denied care due.
"In typical Democrat fear-mongering fashion, they have ginned up another false claim about the American Health Care Act," Davidson responded. "The AHCA preserves current health care law regarding what is called ‘guaranteed issue.' That means that Americans cannot be denied coverage because of pre-existing conditions."
Rep. Thomas Massie (R-Garrison)
The lone local dissenter was Northern Kentucky Rep. Thomas Massie, a member of the ultra-conservative Freedom Caucus. Massie, a longtime advocate of large-scale government deregulation, wrote in a statement that the AHCA didn't go far enough and "falls far short of our promise to repeal Obamacare."
"This bill should have included measures that allow Americans to take charge of their own healthcare and get the government out of the way," he wrote.
His antipathy toward the bill isn't a recent development. He's called it a "stinking pile of garbage," and ahead of the first planned vote, he posted on Twitter that his vote wouldn't be a "yes" or a "no" -- it'd be a "Hell no," thank you.