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Economic and Employment Consequences for States

Public opinion regarding the Republican House (AHCA) and Senate (BCRA) bills was very negative (i.e., opposed), with approval ratings between 12-38%, and disapproval ratings between 41% and 62%, measured between March and June 2017 (refer to “Specific poll results” table below for sources). Views were split along party lines. For example, the monthly Kaiser Family Foundation health tracking poll for May 2017 indicated that:

  • More view the Republican AHCA unfavorably (55%) than favorably (31%).
  • Views are split along party lines, with % in favor of AHCA: Democrats 8%, Independents 30%, Republicans 67%.
  • Although historically more people viewed the current law (ACA/”Obamacare”) unfavorably than favorably, in May 2017 more had a favorable view (49%) than unfavorable (42%).
  • More favorably view the ACA/Obamacare (49%) than the Republican AHCA (31%).[57]

Health care experts from across the political spectrum – liberal, moderate, and conservative – agreed that the House Republican health care bill was unworkable and suffered from fatal flaws, although specific objections varied depending on ideological perspective.[58] Experts agreed that the bill fell far short of the goals laid forth by President Donald Trumpduring his 2016 campaign – “Affordable coverage for everyone; lower deductibles and health care costs; better care; and zero cuts to Medicaid” – because the bill was (1) “almost certain” to reduce overall health care coverage and increase deductibles and (2) would phase out the Medicaid expansion.[58] Among the key concerns identified by health-care experts were that (1) the tax credits funded at the level proposed in the bill are insufficient to pay for individual insurance, and could lead to Americans dropping out of the health care market;[59][60] (2) the bill’s elimination of the ACA’s community rating provision (barring insurance companies from charging older people more than three times what they charge younger people) would increase cost disparities between age groups and would increase premiums for Americans more prone to illness;[60] (3) the dropping of healthy people from the health insurance market (adverse selection[58]) could lead to insurer “death spirals” that would decrease choice; and (4) the phaseout of the Medicaid expansion was likely to result in a loss of healthcare for poorer Americans.[60]