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The First 100 Days

Health Care Reform: First 100 Days Recap

Congress has been deeply divided over implementation of the Patient Protection and Affordable Care Act (PPACA), the health reform law enacted in March 2010. The 2016 election of Donald Trump as president represented a watershed moment for this legislation. On the campaign trail, President Trump publicly backed the Republican effort to undo the law, dubbed "repeal and replace," and set the stage for a sustained push in Congress to reshape the nation's complicated health care system.


January 20, 2017:

Within hours of his inauguration, President Trump signed an executive order directing federal agencies to “minimize the economic burdens” caused by the PPACA. According to Congressional Quarterly, the order does not explicitly grant federal agencies any new authority. Instead, the order instructs the secretary of the Department of Health and Human Services and the leaders of other agencies to “waive, defer, grant exemptions from, or delay” implementation of any provisions within the law that would fiscally burden states, hospitals, insurers, patients, or drug and device manufacturers.


March 6, 2017:

In Congress, the “repeal and replace” legislative action has been a focus of the House of Representatives, where Republicans have a majority. House Speaker Paul Ryan introduced The American Health Care Act (AHCA) on March 6, 2017.


March 9, 2017:

The bill was approved by House Energy and Commerce Ways and Means Committees.


March 13, 2017:

The nonpartisan Congressional Budget Office released a report that found the bill would cause 24 million Americans to lose their coverage, doubling the number of uninsured Americans. Faced with a barrage of criticism from Democrats and the moderate and conservative wings of the GOP, Ryan informed President Trump that there were not enough votes to pass the bill and canceled a scheduled vote on AHCA on March 24, 2017.


April 25, 2017:

Since March, House Republicans have continued to discuss ways to gain support for the AHCA. On April 25, 2017, an eight-page amendment to the AHCA drafted by a pair of lawmakers representing the more conservative and moderate branches of the House Republican conference, Reps. Mark Meadows, R-NC, and Tom MacArthur, R-NJ was released. According to Politico, “The amendment would allow states to opt out of Obamacare's regulations on essential health benefits, community rating requirements, and how much older Americans are charged for coverage. The revised bill also would permit states to reject the continuous coverage provision that Republicans have proposed in their replacement bill. Further amendments increased the appropriation of “high risk pool” funds for states to offset the costs of its sickest and most costly populations, alleviating concerns from moderate Republicans concerned over pre-existing conditions.


May 4, 2017:

The House of Representatives passed The American Health Care Act by two votes. This is only the beginning of the process, however. For a bill to become law, both the House and Senate must agree on it and the President must approve it. Republicans plan to use reconciliation to pass AHCA in the Senate. (Still need reconciliation elaboration here) With a 52-person majority in the Senate, this fast-track budget process allows Senate Republicans to circumvent the 60 vote threshold needed for passage. It only takes a simple majority, typically 51 votes, in the Senate to pass a reconciliation bill.


May 25, 2017:

CBO issues report saying AHCA would result in 23 million people losing coverage by 2026, and that premiums would be higher in 2018, but lower by 2026 than under current law." 


The future of the AHCA and other health care reform actions on Capitol Hill remain very fluid and are changing daily.

News and Media

August 3, 2017:
Senators Plan Bipartisan Hearings On Health Care

Dave Anderson, CEO of HealthNow New York, talks with Steve Inskeep about lawmakers' plans to hold bipartisan hearings on health insurance exchanges. NPR's Scott Horsley has details and analysis.


June 6, 2017:
What's next for the American Health Care Act

The Point of Health podcast features Donald Ingalls, Vice President, State and Federal Relations of BlueCross BlueShield of Western New York. The episode covers the latest updates on Republican's efforts to repeal and replace the Affordable Care Act.


Need to understand a term?

View our helpful Health Care Reform Glossary to understand frequent terms and definitions.


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