密歇根新闻广播 在特朗普医保政策下 有些人就医会更困难（在线收听）

On Thursday, the U.S. House approved a new health care policy designed by Republicans representatives to replace Obamacare. Each one of Michigan's Republican representatives voted in favor of the replacement bill, while no Democrats (in Michigan or any other state) gave the bill their support.

Michigan Republicans were likewise united in the condemnation of Obamacare – also known as the Affordable Care Act (ACA). Representative Tim Walberg, for instance, said, "Obamacare is on the brink of collapse and has failed to live up to its many promises."

Representative John Moolenar called the ACA, "the collapsing health care law."

Not everyone agrees with those assessments.

John Ayanian is the Director of the Institute for Healthcare Policy and Innovation at the University of Michigan. He said that while the Affordable Care Act is not without its flaws, it "has done a lot of good over the past several years."

He highlighted the Healthy Michigan Plan, which was created through the ACA's Medicaid expansion, as an example of one piece of the health care law that has worked.

"It's expanded coverage to about 650,000 adults in Michigan between ages 18 and 64," he told Stateside. "So it's really had an important impact on access to care and reducing the financial stress that goes with being uninsured for Michigan adults."

Ayanian noted that so-called "charity care" – urgent care of uninsured patients for which hospitals receive no compensation – has gone down by 50% since implementation of the ACA. That has strengthened the financial prospects of many hospitals in Michigan, allowing them to focus on providing better care.

As for the replacement bill, the American Health Care Act (ACHA), the path to passage remains daunting. Before becoming law, the bill must work its way through the U.S. Senate, where it is sure to undergo significant changes. Senate rules will make portions of the ACHA impossible to pass without the support of at least a few Democrats.

If the bill does reach the President's desk in its current form, the ACHA is likely to produce some winners and losers.

Ayanian said that an analysis of a prior version of the bill by the Congressional Budget Office found that, "older, sicker, and less wealthy adults – particularly those over age 50, with chronic conditions and lower incomes – they could see their costs of health insurance and out-of-pocket spending for medical care go up substantially."

Listen to our full interview with John Ayanian, Director of the Institute for Healthcare Policy and Innovation at the University of Michigan, above.