Thanks to a fissure between moderate Republicans unhappy with the legislation's cuts to their voting bloc and the far-right Freedom Caucus that wanted an even more hard-line bill, the American Health Care Act could not find the requisite votes for passage.
Simply, their proposal will increase premiums, reduce the quality of coverage and leave tens of millions of Americans without insurance.
Replacing the Affordable Care Act (ACA) has always been a goal of the GOP - but getting rid of Obamacare may actually hurt the voter base that helped put them in power.
Despite this uncertainty, employers and plan administrators should continue to comply with the ACA's mandates, including the employer shared responsibility mandate and ACA reporting. Republicans and democrats appear to be busy focusing attention on their disdain for each other while the rest of us continue to fork over sky-high premiums each month. But if they left the group market they could face high premiums, exclusions and even denial of coverage because of a pre-existing condition - even if they had been paying premiums in the group market for their entire adult lives.
First and foremost, for the first time we gave 23 million Americans who now get nothing from the ACA the money to buy insurance. Together, those provisions would amount to an unfair "age tax" on older Americans, according to AARP. Most of those so-called savings from the most vulnerable in our communities would then have been given in tax breaks to insurance and drug companies, and to the wealthiest Americans.
Older Americans will pay much more and anyone who allows their plan to lapse will pay a 30 percent fee once they resume coverage. Let's not forget that he voted more than 60 times to repeal the ACA. But one aspect of the amendment is raising fresh alarm in some quarters: A clause that would affect new mothers who receive Medicaid.
Additionally, the expansion of Medicaid under the ACA did the opposite of what Medicaid was originally meant to do - it expanded Medicaid coverage to millions of able-bodied, childless, non-elderly Americans. At the very least, the plan would place federal caps on Medicaid spending, shifting the burden, over time, to the states.
The working poor and seniors would have been hit hardest under the AHCA, which would have rationed Medicaid through a block grant program to the states. Republicans argued for years that this was one of the reasons why health plans were not more affordable. Yet instead of living by Reagan's rule, Republicans are hung up on the Hastert Rule, named for Dennis Hastert, the former - and now disgraced - House speaker: Only bills that can get through without Democratic votes are brought to the floor.
But until everyone agrees with that something, the Affordable Care Act will stay. And it was a stark reminder of how much easier it is to be the opposition party and be against everything rather than write viable public policy and actually pass legislation.