The Two Uncomfortable Truths About Healthcare That the GOP Never Acknowledged

With the American Health Care Act pulled and not coming back anytime soon, there are two facts that Republicans will have to acknowledge if they were to try healthcare reform again.



So… the American Health Care Act is dead!



In the 23rd hour, Republicans pulled the AHCA from a formal vote and the blame game by many Republicans in Washington is fierce right now. But if Republicans tried to pass healthcare legislation once again, they would have to face two uncomfortable truths regarding their vision of what healthcare reform should be.    



Uncomfortable Truth #1: You Can’t Cut Costs Without Cutting Coverage


The Congressional Budget Office’s assessment of the American Health Care Act (AHCA) said it best, “enacting the American Health Care Act would reduce federal deficits by $337 billion over the coming decade and increase the number of people who are uninsured by 24 million in 2026 relative to current law.” In other words, you can’t cut the cost of healthcare on the federal government without leaving millions of people uninsured.


Now there are some in the Republican Party, most notably the House’s Freedom Caucus, that feel lowering the financial burden of healthcare is more important that the expansion of it. As we said in our 10-Point Expert on the American Health Care Act, the healthcare bill that the Trump administration and Speaker of the House Paul Ryan presented was more focused about slashing costs and less worried about expanding healthcare coverage. Both Speaker Ryan and the Trump administration “chose a side” when creating healthcare legislation that made cost cutting the paramount focus. For other Republicans, this was just not possible. Which gets us to our second uncomfortable truth…



Uncomfortable Truth #2: Cutting Healthcare Costs Hurt Conservative Rural Areas the Most


As we said earlier, if you want to cut the cost of healthcare at the federal level, you’re going to have to shrink healthcare coverage for millions of Americans. For many Republicans however, that would be a major problem.



As the above video shows, many of those individuals that rely on the Affordable Care Act (aka Obamacare) are usually those that live in conservative-rural areas. An analysis from the Kaiser Family Foundation – a non-governmental group that studies healthcare legislation – around 6.3 million individuals that used the ACA marketplaces were from Republican Congressional districts and favored Donald Trump over Hillary Clinton in the 2016 presidential contest. When these rural communities are compared to metropolitan ones in terms of healthcare coverage, the rural communities are more likely to have public coverage. In other words, rural communities rely on Obamacare more than most would assume.


In regards to the AHCA legislation, there were provisions for cost cutting measures that included a repeal on setting limits that insurance companies could charge for older/sicker customers. In the case for more rural areas, where there is less competition, those older/sicker individuals living in these areas would be paying a whole lot more for health insurance (ie Republican voters). And as the above video demonstrates, those Republican voters knew exactly what that consequence was.


At the end of the day, the AHCA failed because many Congressional Republicans weren’t ready to risk their House seat for their vision of American healthcare. If Republicans are going to try this process again, they’re going to have deal with the realities of balancing coverage and cost when it comes to healthcare reform.



(Photo Credit: CSPAN YouTube Channel,



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