Hospitals, doctors, health insurers and some consumer groups, with few exceptions, are speaking with one voice and urging significant changes to the Republican healthcare legislation that passed the House on Thursday.
The bill’s impact is wide-ranging, potentially affecting not only the millions who could lose coverage through deep cuts in Medicaid or no longer be able to afford to buy coverage in the state marketplaces. With states allowed to seek waivers from providing certain benefits, employers big and small could scale back what they pay for each year or reimpose lifetime limits on coverage. In particular, small businesses, some of which were strongly opposed to the Affordable Care Act, could be free to drop coverage with no penalty.
The prospect of millions of people unable to afford coverage led to an outcry from the healthcare industry as well as consumer groups. They found an uncommon ally in some insurers, who rely heavily on Medicaid and Medicare as mainstays of their business and hope the Senate will be more receptive to their concerns.
“To me, this is not a reform,” said Michael J. Dowling, the chief executive of Northwell Health, a large health system in New York. “This is just a debacle.”
After the House passed the bill Thursday, the insurance industry’s two major trade groups urged lawmakers to increase the tax credits available to help people pay for coverage, and to adjust them to assist those who are older, live in high-cost areas or have lower incomes.
But the overriding concern is the broad reductions proposed for Medicaid. Even for insurers that have largely abandoned the individual market, like UnitedHealth Group and Aetna, a substantial portion of their business is providing coverage under Medicaid.
Employers and others said they were also concerned about the effects on freelancers, who are self-employed, or contract workers in the so-called gig economy.
Depending on their income, those workers have shuttled between Medicaid and the individual insurance market under the federal health care law, which offered a greater level of stability, said Nell Abernathy, vice president of research and policy at the Roosevelt Institute, a left-leaning economic research organisation.
Donald Trump's first 100 days: in cartoons
Donald Trump's first 100 days: in cartoons
Donald Trump's first 100 days in office were marred by a string of scandals, many of which caught the eye of the Independent's cartoonists
Trump's first 100 days have seen him aggressively ramp up tensions with his nuclear rivals in North Korea
Mr Trump has warned of a "major, major conflict" with the pariah nation lead by Kim Jong Un
Mr Trump dropped the "mother of all bombs" on alleged ISIS-linked militants in Afghanistan, amid an escalation of US military intervention around the globe
Mr Trump has been accused of falling short of the standards set by his predecessors in the Oval Office, including Franklin D Roosevelt
The tycoon's ascension to the White House came at a time when the balance of power is shifting away from Western nations like those in the G7 group
Western politicians, including the British Conservative party, have been accused of falling in line behind Mr Trump's proposals
Brexit is seen to have weakened Britain, reducing still further any political will to resist American leadership
Mr Trump's leadership has been marked by sudden and unexpected shifts in global policy
Trump's controversial missile strike on Syria, which killed several citizens, was seen by some analysts as an attempt to distract from his policy elsewhere
The President has also spent a large majority of his weekends golfing, rather than attending to matters of state
Though free of gaffes, a visit from Chinese president Xi Jinping spotlighted trade tensions between the two states
One major and unexpected setback came when Mr Trump's Healthcare Bill was struck down by members of his own party
Mr Trump has been a figure of fun in the media, with his approval at record lows
A string of revelations about Mr Trump's financial indiscretions did not mar his surge to the White House
Outgoing President Barack Obama was accused of wiretapping Trump Tower by his successor in America's highest office
The alleged involvement of Russian intelligence operatives in securing Mr Trump the presidency prompted harsh criticism
The explosive resignation of Security Adviser Michael Flynn, who lied about his links to the Russian ambassador, was just one scandal to hit the President
Many scandals, such as the accusation Barack Obama was implicated in phone-hacking, first broke on Mr Trump's Twitter feed
Donald Trump's election provoked mass protests in the UK, with millions signing a petition to ban him from the country
Donald Trump cited a non-existent terror attack in Sweden during a campaign rally
Donald Trump stands accused of stoking regional tensions in Eastern Asia
North Korea has launched a number of failed nuclear tests since Mr Trump took power
Theresa May formally rejected the petition calling for Mr Trump to be banned from the UK
When Mr Trump's initial so-called Muslim ban was struck down by a federal justice, the President mocked the 69-year-old as a "ridiculous", "so-called judge"
A week after his inauguration, Theresa May met with Mr Trump at the White House
Donald Trump's first days in office were marked by a hasty attempt to follow through on many of his campaign promises, including the so-called Muslim ban
Donald Trump's decision to ban citizens of many majority-Muslim countries from the US sparked mass protests
Revelations about Donald Trump's sexual improprieties were not enough to keep him from being elected President
British PM Theresa May was criticised by many in the press for cosying up to the new President
One of Mr Trump's top aides, Kelly Anne Conway, was mocked for describing mistruths as "alternative facts"
British PM Theresa May was quick to demonstrate that her political aims did not hugely differ from Mr Trump's
Donald Trump's inauguration, on 20 January 2017, sparked protests both at home and abroad
“A huge swath of Americans are in insecure work arrangements,” she said. “This repeals that level of security, which was not perfect, but it was a step in the right direction."
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