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Life After the House Vote
One thing is clear: The Senate will not act nearly as rashly and quickly as the House. They are under less pressure to produce something but under more pressure to produce a "solution." Some is due to procedural issues. Also, both the House and Senate are under pressure to produce legislative victories in other areas. Mainly, however, it's a result of the Senate recognizing that making changes to something as essential as health care is a daunting task fraught with challenges. (Who knew health care was this complicated?).
What's next?
The Senate has quite a task ahead. It has to try to craft a bill that maintains those popular elements of the ACA (like coverage for kids up to age 26, guaranteed coverage for those with pre-existing conditions), more smoothly transitions Medicaid expansion states away from the enhanced reimbursement that the House ripped away in their version of the bill, and holds up against a budget reconciliation process which limits the types of changes that can pass with a simple majority. All this while the House waits to see what comes back for them to consider.
There is plenty of speculation about what this Senate version of the AHCA will look like. Links to some good analysis:
One thing is for sure, if the passage of the House version of the AHCA was a barn burner, the Senate version will be a slow flame. It's gonna take a while. The latest estimate is mid-August.
How does this impact Illinois?
Mainly, this means that Illinois, like most states, will have to work with a federal government that is interested in giving the states more flexibility in how they run Medicaid. A recent HHS letter to states made it clear that CMS is looking for "innovation." States across the country know that only so much change can occur through legislation. State plan amendments and waivers are on the docket as well as legislation meant to push states closer to this new Medicaid reality.
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