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AHCA Passed by the House – May 4, 2017 Update

The American Healthcare Act, or AHCA (HR 1628), passed in the House of Representatives today by a 217-213 vote. The bill effectively repeals or at least significantly revises Obamacare (the ACA). The bill still must be voted on in the Senate, and there is a high likelihood that it will not pass there without significant modification. There are some common misconceptions about the bill, and it has undergone significant alterations since the original version proposed in March. A summary of the key findings is listed below.

House Version of AHCA, HR 1628, Summary

  •  CBO estimates

    • Current CBO projections are not available. The original CBO estimates projected that 10-24 million would lose coverage over 10 years, with a cost savings of 337 billion. Those numbers will likely change significantly with the edits contained in the passed version of the bill.
  • MacArthur Amendment

    • This amendment (Rep. Tom MacArthur, R-New Jersey) would provide states with more freedom and the ability to opt out of the “essential health benefits” that were required in Obamacare. Many critics felt that these requirements unnecessarily inflated health insurance premiums under the Affordable Care Act. States will now be able to develop their own lists of what they consider essential.
    • This amendment also allows insurance companies to charge patients more for premiums if they have gone “uncovered,” or have not been enrolled in an insurance plan, for greater than 63 days, and they have pre-existing conditions. Despite what has been reported in the media, this amendment would not allow insurance premiums to rise for patients with pre-existing conditions if they maintained health insurance coverage. Furthermore, it would limit the increased premiums to one year.
    • States who allow this type of medical underwriting (researching the health states of their patients when determining premiums) would also be forced to create a “high risk pool” that would provide funds to care for patients with multiple medical comorbidities.
  • Upton Amendment

    • This amendment (Reps. Fred Upton, R-Michigan, and Billy Long, R-Missouri) provided an extra $8 billion over 5 years to create the high-risk pools that will cover patients with pre-existing conditions. This is in addition to the $150 billion already provided in the bill for high-risk pools.
  • McSally Amendment

    • This amendment (Rep. Martha McSally, R-Arizona) would prevent members of Congress from exempting themselves from the AHCA. In effect, this amendment forces them to purchase insurance under the same guidelines as the rest of the country.

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