Repealing and Replacing Obamacare Becomes Retreating and Regrouping

The bill to repeal and replace Obamacare failed to gather enough support from Republicans to overcome united opposition from Democrats, and was not brought to the House floor for a vote. The repeal was not complete enough for some conservatives and the replace was too generous for them, while it was not generous enough for some moderates.

This is welcome news for mental health professionals and many of their clients/patients because the latest version of the bill would have resulted in 24 million fewer people having health insurance in ten years than under current law, according to the Congressional Budget Office.

Mental health funding became a bargaining chip when the ten essential coverages insurers must provide, including mental health, were eliminated to gain more votes from conservatives. Then, at the last minute,  $15 billion was added to the $100 billion Stability Fund and earmarked for behavioral health and maternity coverage in a bid to gain support from wavering moderates. In the big picture, the $15 billion was far from enough to compensate from the overall loss of coverage nationally. 

Ultimately the bill failed to appeal to a broad enough coalition of Republicans. Efforts to appeal to conservatives drove moderates away and vice versa. The President's efforts to persuade wavering Republicans fell short after he declared that the bill should be brought to a vote without further modifications or debate. That gambit failed.

Obamacare remains in place for the foreseeable future. The President says he will move on to other issues. It is working well in some areas of the country and not well enough in others where not enough insurers participate. There are regulatory steps the Administration could take to further weaken the program or to strengthen it. There are steps Congress could take to shore it up with Democratic support. The insurance companies will make business decisions about participating going forward.

This bill was rushed through the House. Perhaps the majorities in the House and Senate will spend months rather than weeks developing a better bill that would gather a majority in both Houses either with or without Democratic support.  For now, it's a good day for everyone who provides mental health services and for those who need them.