New US health bill will reopen Republican splits

Significance

The proposal, which passed the House by a slim 217-213 margin after a failed attempt in March, seeks to repeal politically controversial portions of Obamacare, especially the insurance purchase mandate. However, it also seeks to avoid retrenching some of Obamacare’s most popular provisions, especially the expanded coverage requirements for insurers.

Impacts

• Republicans from moderate districts will be squeezed between the demands of their party leaders, core voters and their broader electorates.
• Insurance market upheaval and coverage loss could see Democrats benefit from greater unity to take advantage of a 2018 electoral backlash.
• If enacted, the AHCA state opt-out could lead to a regulatory race to the bottom as insurers move to states with low coverage requirements.