With the House vote on the American Health Care Act (AHCA) looming for Thursday and concern of its approval among conservatives in the House, GOP leadership has added a “manager’s amendment” to the AHCA that would make the AHCA even more conservative. How so? By not only ending Medicaid expansion on December 31, 2017 but by also adding a work requirement to qualify for Medicaid that may take effect as quickly as October 1, 2017.
The amendment would allow states to impose a work requirement for nondisabled, nonelderly, non-pregnant adults as a condition to obtaining Medicaid coverage. This work requirement, which may be satisfied by having a job as well as job searching, readiness or training, is modeled from the work requirement for receiving benefits under the Temporary Assistance for Needy Families (TANF) program.
While such a conservative approach to Medicaid may be welcomed by some hard right Republicans, the reception may not be as warm among more moderate Republicans and more significantly other hard right Republicans. The AHCA was amended in search of more Republican votes. However, to some conservative Republican House members, the cuts to Medicaid through AHCA as amended are still not conservative enough.
With only two days before the House vote, the success of the AHCA as amended looks dubious. Mark Meadows, who heads the Freedom Caucus, a conservative group among House Republicans, stated that there are still insufficient votes for the AHCA to pass the House.
It is unclear whether the Republican majority (which can lose no more than 21 votes) will have sufficient votes on Thursday to pass the AHCA in the House. With only a slight majority in the Senate (which can lose no more than 2 votes), the AHCA, as amended, is even less clear.
