As the Trump presidency continues to move through its first 100 days, another campaign promise is beginning to come to fruition — the dismantling of the Affordable Care Act (ACA). Dubbed one of the largest healthcare reform measures, it has been plagued with controversy and growing pains as its implementation has rolled out. With Republicans holding the presidency and both houses of Congress, the time to make changes was seized.

The replacement healthcare bill, titled "The American Health Care Act," was recently introduced, and has now successfully passed a second House committee. The 123-page bill was met with much opposition in the House Energy and Commerce Committee, but was eventually passed after hearings that lasted 27 hours and 18 minutes.

The bill will soon move to a full House vote, expected in the next week, while Senate leaders are pressing for a Senate vote before Easter break, which starts April 7.

President Trump expects the bill to help decrease costs, expand choices by creating a free market and, in turn, increase access to health care. He hopes to return the power to the people. where they can again choose their doctors and choose plans that work best for them and their families.

Current key issues of the bill include:

  • Removing the individual mandate that requires all Americans to purchase insurance or face a fine, retroactively effective for the 2016 year.
  • Continuing to allow people with pre-existing conditions to have access to coverage, but penalties will be implemented for lapses in coverage.
  • Establish new premium tax credits based on age, which will assist people in buying insurance.
  • Providing grants to establish high-risk pools and encourage enrollment.
  • Repeal of ACA taxes that finance the law’s subsidies, Medicaid expansion and Medicare benefit enhancement.
  • Raising the age ratio insurers can charge older customers to five times premium vs. ACA’s three times premium ratio.
  • Prohibits direct spending of federal dollars on any "prohibited entity," including those that provide abortions for anything other than the life of the mother, incest or rape.
  • Capped per-capita federal grants to states.
  • Disallowing Americans who received a lump sum or large payment from winning the lottery from receiving Medicaid assistance.

Although the bill is moving quickly through House committees, it is not without opposition. The American Medical Association sent a letter to the leaders of the House committees expressing its concerns of the potential loss of insured Americans. That concern was shared by the American Hospital Association, American Nurses Association and AARP.

What was glaringly missing from the revisions was any discussion of changes to Medicare’s very unpopular reimbursements tied to patient satisfaction surveys. Considering most voters would likely endorse keeping their power, it is curious that none of the professional organizations have taken positions to have these aspects removed.

Whether healthcare workers are in total agreement for the proposed repeals, a few things are for certain — it will be turbulent times and healthcare workers must continue to stay informed.