1. Health Reform in the Trump Era
Presented By Cate McCanless
Policy Director, Brownstein Hyatt Farber Schreck

2. Roadmap Health Care in the First 100 days
Timeline of the AHCA legislative process
Status of the “Law of the Land” - ACA
Politics & policy
Lessons learned from AHCA
Future of “Repeal and Replace”
Looking Forward
How the HHS Secretary can begin to unilaterally dismantle the ACA
2017 Inflection Points
Getting Involved

3. AHCA Timeline

4. AHCA By The Numbers

5. Roadmap Health Care in the First 100 days
Timeline of the AHCA legislative process
Status of the “Law of the Land” - ACA
Politics & policy
Lessons learned from AHCA
Future of “Repeal and Replace”
Looking Forward
How the HHS Secretary can begin to unilaterally dismantle the ACA
2017 Inflection Points
Getting Involved

6. MacArthur Amendment Insurance Market Provisions
Reinstate Essential Health Benefits as the federal standard and maintain the following provisions of the AHCA:
Prohibition on denying coverage due to preexisting medical conditions
Prohibition on discrimination based on gender
Guaranteed issue of coverage to all applicants
Guaranteed renewability of coverage
Coverage of dependents on parents’ plan up to age 26
Community Rating Rules, except for limited waivers
Limited Waiver Option
States can seek Limited Waivers from certain federal standards, including:
Essential Health Benefits
Community rating rules, except for the following categories, which are not waivable:
Gender
Age (except for reductions of the 5:1 age ratio previously established)
Health Status (unless the state has established a high risk pool or is participating in a federal high risk pool)
Limited Waiver Requirements – Waivers must be designed to reduce premium costs or increase health care coverage.

7. Lessons learned from AHCA legislative exercise
Polarized sources of money in politics
It is now easier than ever for members of Congress to connect with small donors throughout the country. Small and individual donors tend to be the most ideologically polarized, which further empowers extreme wings of the parties
Independence of individual members of Congress
Individual members of Congress have become more willing to act independently of their party’s leadership 4 1 2
Heightened influence of well-funded outside groups
There has been a transfer of influence from political parties to well-funded outside groups that are willing to support Republican representatives who take stances on issues that align with the group 5
Reduced importance of congressional committee assignments
Committees did not play a central role in crafting the AHCA. Now, committee assignments are less necessary for PR and fundraising purposes, meaning less leverage for leadership 3
Less reliance on party infrastructure
Many members of Congress now depend less on the party’s financial assistance and support. An example of this was the Koch network’s willingness to support those who buck party leadership 6
Impact of elimination of earmarks
The elimination of earmarks has stripped a tool that party leaders could have used to entice members to support certain legislation

8. What is the future of “Repeal and Replace”?

9. Roadmap Health Care in the First 100 days
Timeline of the AHCA legislative process
Status of the “Law of the Land” - ACA
Politics & policy
Lessons learned from AHCA
Future of “Repeal and Replace”
Looking Forward
How the HHS Secretary can begin to unilaterally dismantle the ACA
2017 Inflection Points
Getting Involved

10. Potential Executive Actions

11. Key healthcare dates and priorities for 2017

12. Importance of Advocacy

13. “NO” Votes – currently 21 (House Republicans can only afford to lose 22*)
Rep. Mark Amodei (NV)
Rep. Leonard Lance (NJ)
Rep. Andy Biggs (AZ)
Rep. Frank LoBiondo (NJ)
Rep. Mike Coffman (CO)
Rep. Thomas Massie (KY)
Rep. Barbara Comstock (VA)
Rep. Patrick Meehan (PA)
Rep. Ryan Costello (PA)
Rep. Ileana Ros-Lehtinen (FL)
Rep. Jeff Denham (CA)
Rep. Chris Smith (NJ)
Rep. Charlie Dent (PA)
Rep. Michael Turner (OH)
Rep. Dan Donovan (NY)
Rep. Daniel Webster (FL)
Rep. Brian Fitzpatrick (PA)
Rep. David Young (IA)
Rep. Jaime Herrera Beutler (WA)
Rep. Walter Jones (NC)
Rep. John Katko (NY)

14. Notable Undecided Votes
Rep. Brian Babin (TX) — The Texas lawmaker, a former member of the Freedom Caucus, was yes on the first bill.
Rep. John Culberson (TX) — Culberson was undecided on the first bill.
Rep. Carlos Curbelo (FL) — Curbelo told The Hill on Wednesday he was undecided on the revised bill.
Rep. Ron DeSantis (FL) — DeSantis was undecided on the first bill.
Rep. Mario Diaz-Balart (FL) — A centrist, Diaz-Balart voted to advance the first bill in the House Budget Committee but said he had "serious concerns.“
Rep. Neal Dunn (FL) — Dunn was undecided on the first bill.
Rep. Rodney Frelinghuysen (NJ) — The chairman of the Appropriations Committee was a no on the first bill.
Rep. Louie Gohmert (TX) — The Freedom Caucus member was a no on the first bill.
Rep. Will Hurd (TX) — Hurd was undecided on the first bill.
Rep. Raúl Labrador (ID) — The Freedom Caucus member was a no on the first bill. 
Rep. Brian Mast (FL) — Mast told CNN he is undecided on the new bill. Mast was a lean yes on the first bill.
Rep. Michael McCaul (TX) — McCaul was undecided on the first bill.
Rep. Steve Pearce (NM) — Pearce was a lean no on the first bill.
Rep. Ted Poe (TX) — Poe was a yes on the first bill.
Rep. Bill Posey (FL) — Posey was a no on the first bill.
Rep. Randy Weber (TX) — The Freedom Caucus member was undecided on the first bill.

15. Questions?
Cate McCanless Policy Director Brownstein Hyatt Farber Schreck