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American Health Care Act (AHCA) passes House, advances to Senate

05/05/2017 11:52 AM | Anonymous

Today (May 4), the House of Representatives passed an amended version of the American Health Care Act (AHCA), H.R. 1628, by a vote of 217-213. This version of AHCA has not yet received a score from the Congressional Budget Office (CBO). In the previous version, CBO estimated that under the AHCA 14 million fewer people would have health insurance coverage in 2018 and 24 million fewer by 2026. Among other changes, this legislation would: 

  • Repeal the Affordable Care Act tax credits and replace them with advanceable, refundable flat tax credits adjusted for age  
  • Impose a 30% late enrollment penalty on premiums for individuals who have lapsed in consecutive coverage for 63 consecutive days or longer
  • Modify the age-rating limit, which would allow insurers to significantly raise premiums for older adults
  • Fund separate state high-risk pools for more expensive patients, which is intended to lower premiums
  • Incentivize the use and expansion of health savings accounts
  • Allow states to apply for waivers that would: 
    • Redefine required coverage for mandated essential health benefits, 
    • Further increase the age rating ratio, or 
    • Eliminate the ban against significant increases in premiums for people with pre-existing conditions; 
  • Repeal the Medicaid expansion program and phase out current enhanced federal matching rates, with certain exceptions
  • Permit states to institute a Medicaid work requirement
  • Allow states to choose between a Medicaid per capita allotment or flexible block grant federal financing structure

The legislation will now be sent to the Senate where it will be subject to debate. All Democratic and many Republican Senators have expressed significant reservations. If the Senate decides to advance the legislation, it is almost certain to be amended, which would require another House vote prior to final passage.   

-This article originally published in the May 4th MGMA Washington Connection

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