“Repeal and Replace” Finally Heads to the House Floor

Whether you call it “Ryancare,” call it “Trumpcare,” or simply call it by its official legislative title (the American Health Care Act), one thing is all but certain: The legislation designed to repeal and replace President Barack Obama’s signature health care law is finally headed to the floor of the House this week (likely on Thursday), where it faces an uncertain fate.

The American Health Care Act has seen opposition from all over the political spectrum since its March 6 introduction, with many moderate Republicans and virtually all Democrats expressing concerns about the fate of underserved patients and communities under the bill, particularly after the bipartisan Congressional Budget Office (CBO) reported that an estimated 24 million people would likely lose their health care coverage in the coming years. State benefits administrators have also voiced disapproval of the plan. Speaking to California Healthline, Cathy Senderling-McDonald, the County Welfare Directors Association of California’s deputy executive director, worried about the impact of the Medicaid cuts on patients in her state, noting that they “could result in people delaying their health care or having to pay out-of-pocket and not having any hope for reimbursement at all.”

For their part, hardline conservatives appear unwilling to accept anything less than a total repeal of the Affordable Care Act, and members of the House Freedom Caucus claimed on Monday that they had enough “no” votes among their ranks to kill the legislation. “We don’t believe that they have 216 votes. In fact, we know that they don’t have 216 votes,” Freedom Caucus member Rep. Raul Labrador (R-ID) told CNN. The bill’s rapid passage through key congressional committees, however, has paved the way for a full House vote, though it would be very unlikely to pass the Senate in its current form.

What, though, does this legislation–and the new Trump administration–mean for current and future telemedicine patients? Trump himself has offered very little in the way of specifics when it comes to health IT or telemedicine-related initiatives, though he has spoken of wanting to give states “flexibility,” and administration officials like HHS Secretary Tom Price and CMS Administrator Seema Verma haven’t been always been particularly enthusiastic about health IT. One danger likely lies in the American Health Care Act’s phasing out of the generous federal funding for state Medicaid programs, to be replaced by block grants; nearly all states offer some form of reimbursement for telemedicine through Medicaid, and a dramatic cut in federal funding could put patient access at risk.

One potential silver lining: Telemedicine has traditionally enjoyed bipartisan support on Capitol Hill, with lawmakers in both parties pointing to the role it can play in cutting costs and increasing access (including for veterans), meaning that future standalone legislation to support its expansion might have a good chance of passage. Further, groups like the Connected Health Initiative, as CTeL and others have previously reported, have been searching for opportunities to expand telemedicine reimbursement under “repeal and replace.” But only time–and this week’s vote–will tell what its prospects really look like.

Click here for the article from CNN on Repeal and Replace.

Click here for article from California Healthline on Repeal and Replace. 

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