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Obituary for the Undead: Last Night Settles Little

All this year, it seems like I’ve been reading obituaries for bills that won’t die.

The Obamacare era is over! The House Affordable Care Act (ACA) repeal is dead! Sen. John McCain cast the deciding vote to repeal the ACA! Wait, McCain cast the deciding vote to save the ACA!

My colleagues at the Colorado Health Institute and I have even written some of these obits ourselves.

Last night, to be sure, was a monumental setback for Republican attempts to repeal the ACA. Republican Sens. McCain, Susan Collins and Lisa Murkowski joined the Democratic caucus to kill a repeal plan introduced by Majority Leader Mitch McConnell less than four hours prior to the fateful vote.

I watched it happen on C-SPAN around midnight as I was trying to finish a presentation for the Boulder County Area Agency on Aging that we had long ago scheduled to deliver this morning. The Congressional Budget Office score of McConnell’s bill had just leaked, and I quickly added the highlights — proud that this CHI presentation would be among the first in the country to cover the updated bill.

And then, the C-SPAN audio fell silent as the video showed senators milling around on the floor. It was clear that something wasn’t going according to plan. About an hour later, McConnell’s amendment was dead.

But here’s the important part — and it’s something you probably won’t read in today’s news coverage. The underlying bill is still alive — waiting in a state of suspended animation and able to be revived at any moment.

That bill, H.R. 1628, the American Health Care Act (AHCA), passed the House on May 4. The Senate tried and failed several times to amend it. Failing to advance a bill is different from killing a bill. We’ve made that mistake before. The AHCA is alive (if not exactly kicking) and it’s likely to remain alive until the Senate either makes another try at passing it or the 115th Congress adjourns in January 2019.

Here’s what else is still alive this morning:

  • The Affordable Care Act — much to the relief of all the people who depend on the coverage the law offers.
  • The problems many Coloradans and Americans have with high insurance premiums and deductibles.
  • The outsized prices we pay for medical care and medication in this country.
  • A drug use problem that is claiming at least 50,000 lives a year — more than car accidents or guns.

And most of all, we have two different visions of how to pay for health insurance — and whether insurance even matters. (We at CHI think it does.)

The ACA is the law of the land. The AHCA is an active bill that is one vote away from overturning the ACA. There’s no consensus between the political parties about which system should prevail.

It’s nearly nine months after Election Day. Maybe after the elation and despair from last night’s legislative drama wear off, we can start to talk about fixing the underlying problems in our costly health care system, rather than who picks up the check.

Look for CHI next week to offer some suggestions on where we can start.