The failure of the American Health Care Act (AHCA), the planned replacement for the Affordable Care Act (ACA), was the first major legislative defeat for President Trump. Critics dubbed the AHCA “Obamacare Lite” for its many market-limiting provisions that would have discouraged improvements in health care while leaving healthy Americans with higher costs—and most everyone with fewer options. Now Republicans in Congress are considering the MacArthur-Meadows amendment to allow states to apply for opt-out waivers for some Obamacare rules, including mandated benefits and required community rating.
Replacing the ACA remains a worthy goal, but only if the new policy allows a freer and more functional health insurance market to emerge. The opt-out provisions of the proposed amendment do not go far enough in this direction.
