Repeal and Replace: The AHCA and what it means for America


Timeline link

On May 4th, the House of Representatives passed the Republicans’ new plan for American healthcare: The American Health Care Act (AHCA). This is the G.O.P.’s second attempt at passing a bill to “repeal and replace” the Affordable Care Act (ACA) that was passed under President Obama in March 2010. Their first attempt, in March of this year, failed spectacularly, as Speaker of the House, Paul Ryan, pulled the bill from the floor before it could be voted on. This legislative defeat lead to questions about Republican leaders’ qualifications at the dawn of the Trump administration and whether President Trump would be able to rely on republican support in congress. The bill had been under major scrutiny by Democrats and Republicans alike: the left arguing that it didn’t cover enough, and the right arguing that it left too much of the ACA in place by maintaining a large federal role in health insurance markets. One major piece of criticism faced by congressmen was the Congressional Budget Office’s (CBO) prediction that through the AHCA would cover over 20 million less Americans than the ACA over the next four years, while simultaneously giving wealthy Americans a tax break in aggregate of over $180 billion. The second bill was quickly pushed to a vote on the house floor before some congressmen had read the entire material, and even before the CBO had a chance to evaluate it – the same rushed process that Paul Ryan criticized the ACA on in 2009 after it was passed in the house. This rushed process, and its apparent hypocrisy, inherently raised the question of Speaker Ryan’s and the other house republicans motives: were they genuinely trying to reform our country’s healthcare? Were they desperately grasping at some form of legislative victory so they could brag about a political victory over Obamacare? Or maybe were they striving for the former, and wound up with something that looked more like the latter? Different media outlets seem to tell different stories.

The Left:


On the left, the New York Times article: “Who Wins and Who Loses in the Latest G.O.P. Health Care Bill” (written by Margot Sanger-Katz) lives up to its title, describing the demographics that would be positively and negatively affected by the bill: the “Winners” and “Losers”. Most of the groups in the “Winners” category are placed there due to the fact that they are either not negatively affected, or positively affected by the changes. The high earners are getting a tax break, the healthy middle class is getting healthcare subsidies back, people who want less coverage are getting that option, large companies will no longer be mandated to provide affordable coverage to their employees, and the medical industries are getting taxes lifted on their products or services. Each of the “Losers” is getting impacted in similarly individual ways, but negatively: Poor people are more likely to not be insured, Older people could be charged multiples of what a younger person would be charged, insurance companies could increase rates for people with pre-existing conditions without penalty, the state governments would lose Medicaid funding and flexibility, planned parenthood would lose funding almost all together, and hospitals, especially in poorer areas, would lose funding and due to less people having insurance, would lose out more from patients that wouldn’t be able to pay for treatment. The article overall outlines details in a somewhat unbiased way but still leaning slightly to the left; however, with her groupings of people, Sanger-Katz is practically saying that the bill would help the rich but it would hurt the poor, the elderly, hospitals themselves, and planned parenthood. This seems to me like a very subtle bias towards the left while still trying to maintain the image of being unbiased.


The New York Times’ article contrasts with another usually liberal publication’s article: The Washington Posts’ “Yes, House Republicans, the heartless health-care vote will define you”, (written by E.J. Dionne Jr.) Right off the bat from the title there is a clear bias of the author towards the left. As Dionne Jr. continues he utilizes vivid, catchy language to slam the bill and the republican party like his dramatic opening sentence: “We should never forget May 4, 2017.” Claiming that the House of Representatives has “descended to a new level of cruelty, irresponsibility and social meanness.”, then renaming it to “the house of Trump”. These statements were accompanied by Dionne Jr. referring to the bill as an “Anti-Health-Care Bill”. The two liberal articles both have political bias but at different degrees and using different methods: extreme, colorful, borderline propaganda language in the Washington Post article, and the subtle suggestions that the G.O.P. wants to kill your grandmother like the New York Times article.

The Right:


The Heritage Foundation’s article “The House Acts on Obamacare. Time for the Senate to Follow Suit” (written by Robert E. Moffit and Jean Morrow) comes from the right side of the spectrum. As can be gleaned from the title, the article comes across essentially as a call to arms for the Senate to fall in line behind the Republican banner. The article then briefly describes the pieces of the bill that would seem appetizing to the typical republican: less government involvement and power to the states. However, then the article seems to fall off in detail as it switches from these pleasant juicy pieces of the bill almost all republicans can get behind to three sentences about the tax cuts in which, there is little to no detail and the author states “In fact, the House bill provides for one of the largest tax reductions on record” and in response the entire republican party begins salivating. The author fails to mention that those tax cuts are meant for already wealthy people, and that in cutting those taxes they are essentially de-funding the Medicaid program. This article does a very good job at telling readers what they want to hear, as The Heritage Foundations is known as a right-leaning source; however, the entire article is basically selecting that information and milking the good stuff for all its got while just barely skimming the less agreeable aspects to continue to appeal to the more moderate republican. Overall, this article is an almost nationalistic, or idealistic, rallying call in attempt to drive support for the bill by selecting the details that are presented to maintain moderate support, while also providing a convenient scapegoat for any speed bumps: the republican senators.

The Middle:

The two neutral articles I used: CBS’ “House Republicans unveil plan for health care overhaul” and Reuters’ “Data Dive: U.S. healthcare, by the numbers” took a similar approach to the material by simply stating the facts. The CBS article was a written account of the provisions of the bill and was devoid of any opinions, rather choosing direct transparency about the bill and expressing criticism and defense from both the right and the left equally. The Reuters article had a slightly easier job since it’s article consisted of statistics comparing the ACA and the AHCA, as well as the US against other countries in different health-related categories. In both articles, it was clear that they existed for the reader to assess and judge on their own rather than providing a predetermined opinion or analysis of the data. I also noted that neither article was attributed to a single author, rather both seemed to be crediting the media outlet itself as the one providing the information.

So What?

 If you go looking for answers or information about the AHCA, what you find will almost certainly be determined based on where you look. The political spectrum is represented well in the media: the generally left-leaning sources like the New York Times and the Washington Post approached the issue with an obvious anti-Trump, anti-right attitude by refusing to acknowledge the upsides of the bill (and thus conceding on principle to the Republicans), rather choosing to highlight what they saw as the detrimental parts of the bill. The right-leaning sources like The Heritage Foundation continued this trend on their side of the spectrum by praising the House and calling for support from the rest of the G.O.P. while gently brushing over aspects of the bill in order to not draw too much attention to what some Americans, or even other republicans, may not agree with. The generally neutral news sources like Reuters and CBS News, in contrast, relied on hard numbers and data or attempted to avoid bias by sticking to fact about the contents of the bill rather than the opinions about the contents of it. This exercise has taught me to be extremely critical of what news is saying. It’s sometimes very hard to see bias in a source and it’s much harder to be critical of a source that aligns with your own beliefs than to be critical of one that’s not. However, I found that the scrutiny that really needs to be there to develop a personal opinion is the criticism of your own side and that I learned more about my position on the topic from criticizing both sides of the spectrum.



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