ACA Replacement Heads to Senate – Updates on the AHCA
On May 4, 2017, in a 217-213 vote, the House of Representatives passed bill H.R. 1628, the American Health Care Act (AHCA). The Republican sponsored bill to “repeal and replace” the Affordable Care Act (ACA), also known as Obamacare, would allow states to allocate Medicaid benefits on a per beneficiary basis, or states could chose to receive a lump sum block grant with less federal regulation. The bill also looks to defund Planned Parenthood.
The AHCA will retain key features of the ACA with additional changes:
- Covered dependents can keep coverage under their parent’s plan until age 26
- Pre-existing conditions would be covered and funded from a newly formed $8 billion fund
- Subsidies for premiums would remain; however, eligibility formulas will be change
- The Marketplace (state exchanges) will continue to offer individual and small business health plan options
- A risk sharing fund of $15 billion would help states offer lower premiums to qualified individuals
- Subsidies would not cover health insurance premiums that cover abortions
- An individual mandate applies with a maximum surcharge of 30% for anyone reapplying for coverage if they have not maintained insurance
The AHCA will also expand Health Savings Accounts (HSAs) with contribution increases that will all for people to receive tax-free savings to pay medical expenses. In addition, federal subsidies will be expanded so that consumers could use the money toward marketplace or private insurance.
In 2020, new Medicaid enrollees will have new eligibility requirements (people already on Medicaid will be allowed to retain their coverage).
The bill does not have the support needed to move forward. However, each year, one bill is allowed to move through the Senate without filibuster, and Republicans are using H.B. 1628 as their choice for this year’s pick. Due to regulation, a full repeal is not allowed under the rules of reconciliation.
Both the House and the Senate must pass a bill before it is sent to the President for signature. The bill is now awaiting Senate review, possibly next week.