The nuts and bolts of the American Health Care Act

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A visit to the homepage of healthcare.gov, the official site of Affordable Care Act, makes no mention of its possible unraveling thanks to the American Health Care Act. The Republican counterproposal to the Affordable Care Act survived a House vote yesterday. The bill must now face a vote of the Senate, with many believing the AHCA won’t become law without some major revisions. Its House passage, however, has been touted by many of President Trump’s supporters, and the president himself, as a huge victory. Much like the ACA’s Democratic party-line passage of the ACA in 2010, the AHCA passed despite not garnering a single Democrat’s vote, as well as the inability to convince 20 Republicans of the replacement’s merits.

As for the bill:

If passed, the law would allow consumers the ability to buy insurance outside of marketplaces created by the ACA and it does away with the personal mandate.
“In place of that mandate, the bill encourages people to maintain coverage by prohibiting insurance companies from cutting them off or charging more for pre-existing conditions as long as their insurance doesn’t lapse. If coverage is interrupted for more than 63 days, however, insurers can charge people a 30 percent penalty over their premium for one year,” according to National Public Radio, which goes on to state, “The House plan would eliminate the income-based tax credits and subsidies available under the Affordable Care Act, replacing them with age-based tax credits ranging from $2,000 a year for people in their 20s to $4,000 a year for those older than 60.”

NPR provides a link to a Kaiser Family Foundation interactive map, which shows how the change would affect specific parts of the country.

As for state waivers, the bill would allow for optional, state-level repeals of the ACA and provide states the ability to opt out of many regulations and consumer protections included in the ACA. The waivers would allow insurance companies to charge older people more than five times what is charged to young people for the same policy; eliminate required coverage, called essential health benefits, including mental health access, maternity care and prescription drugs required under the ACA; and charge more for or deny coverage to people who have pre-existing  conditions.

“The waivers could also impact people with employer-based insurance, because insurers could offer policies that have annual and lifetime benefit limits, which are banned under the Affordable Care Act, and some companies may choose those policies for their workers to lower premiums,” according to NPR.

Provisions in the new bill however, including waivers and grants,  mean it is still unclear how changes would affect March’s CBO score.

 

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