Today is a momentous day for America to get back on track to becoming great again. Why? Because the House of Representatives is voting to repeal the Affordable Care Act (ACA) and replace it with the American Health Care Act (AHCA).
We’ve outlined the major differences between the current bill and the proposed House Republican bill in this table below.
Recently, the House Republican leaders have proposed changes to the bill, these changes are highlighted.
House Republican Bill
|The Affordable Care Act requires people who can afford it to obtain health insurance or face tax penalties. This part of the law was meant to keep insurance affordable for those who are older or sick.||The Republican bill would eliminate the individual mandate, which means that people would not have to pay a penalty if they went without insurance. One possible effect, though, is that healthy people might be less likely to buy insurance, driving up prices for those who need it most, like older people and the sick. To limit this, the plan proposes a “continuous coverage incentive,” which would charge people in the individual market a 30 percent penalty for lapses in health insurance coverage.|
|Larger companies must provide affordable insurance to their employees or face financial penalties.|
|Subsidies for out-of-pocket expenses||Repeal|
|The federal government provides tax credits to help some people pay deductibles and make co-payments.||Would repeal this so-called cost-sharing subsidy in 2020.|
|The federal government provides tax credits to middle-income Americans on a sliding scale according to income, to help offset the cost of premiums and deductibles.||Would change the way subsidies are distributed by using age, instead of income, as a way to calculate how much people receive. Tax credits would be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they would be capped for higher earners. The subsidy would be $2,000 for a person under 30, and double that for people over 60. The bill would also expand the health plans that qualify for subsidies. The amendment would also allow people to deduct more health care expenses from their income taxes, a provision that might be changed in the Senate to instead increase tax credits to older insurance buyers.|
|More than 30 states expanded Medicaid coverage by raising the eligibility cutoff to 138 percent of the poverty level.||Would let states keep Medicaid expansion and allow states that expanded Medicaid to continue getting federal funding as they would have under the A.C.A., until 2020. Federal funding for people who became newly eligible starting in 2020 or who left the program and came back, however, would be reduced. The bill also proposes capping federal funding per enrollee, based on how much each state was spending in 2016. The amendment would allow states to impose work requirements for some Medicaid beneficiaries and give states the option to receive a lump-sum block grant for Medicaid, rather than per capita funding. States that haven’t expanded Medicaid already would not be allowed to do so in the future. It would also stop allowing states to cover adults with incomes above 133 percent of the federal poverty level after this year.|
|Health savings account||Change|
|In 2017, an individual can put $3,400 and a family $6,750 into a tax-free health savings account.||Would allow people to put substantially more money into their health savings accounts and let spouses make additional contributions. The basic limit would be at least $6,550 for an individual and $13,100 for a family beginning in 2018. The amendment would no longer allow consumers to roll over excess tax credit money into a health savings account.|
|Restrictions on charging more for older Americans||Change|
|Plans can charge their oldest customers only three times the prices charged to the youngest ones.||Would allow insurers to charge older customers five times as much as younger ones and give states the option to set their own ratio.|
|Dependent coverage until 26||Keep|
|Children can stay on their parents’ insurance policies until age 26.|
|Pre-existing conditions policy||Keep|
|Requires insurers to cover people regardless of pre-existing medical conditions and bars the companies from charging more based on a person’s health history.|
|Essential health benefits||Keep|
|All insurers must offer 10 essential health benefits, including maternity care and preventive services.|
|Prohibitions on annual and lifetime limits||Keep|
|Insurers are barred from setting a limit on how much they have to pay to cover someone.|