CBO-Cost Estimates

Trump Care virtually Dead

Official Summary from Congress.Gov

Find out the latest in the actual health care law from the rest of our website



Despite the decision not to proceed with the bill this week, the repeal-and-replace drama may not be over. Some GOP senators are pushing to include the healthcare overhaul in a 2018 budget bill containing the Republican tax overhaul package, even though political observers warn that could jeopardize the tax bill. Modern Health Care

Graham Cassidy *  Amendment

Senate Bill dies  Modern Health Care 7.17.2017 – Fix ACA?  Subsidies?

Senate Version to be released Thursday 6.22.2017 per CA Health Line

Introduced in House (03/20/2017)   AHCA passes House  Thursday 5.4.2017

American Health Care Act of 2017

The Patient Protection and Affordable Care Act (PPACA) will be amended to eliminate funding for the Prevention and Public Health Fund and increase funding for community health centers.

For one year, certain federal funds may not be made available to states for payments to certain family planning providers (e.g., Planned Parenthood Federation of America).

–prohibit federal Medicaid funding for Planned Parenthood or any organization that performs abortions, and bar use of tax credits for purchase of any health plan that covers abortions.

AHCA amends title XIX (Medicaid) of the Social Security Act (SSAct) to limit, based on enrollment, federal funding for Medicaid beginning in FY 2020.

Beginning in 2020, the bill eliminates:

(1) the enhanced federal matching rate for new enrollees made eligible for Medicaid by PPACA,

Changes Medicaid from an open-ended program to one that gives states fixed amounts of money per person (block grants).


(2) the state option to extend Medicaid coverage to such enrollees. At least every six months, states must redetermine the eligibility of enrollees made eligible for Medicaid by PPACA.

repeals other changes made to Medicaid by PPACA and modifies additional Medicaid provisions.

Cost sharing reductions for low income individuals are eliminated after 2019.  Sec. 131. Repeal of cost-sharing subsidy.

Patient and State Stability Fund Sec. 132. Patient and State Stability Fund.to provide funding to states for the stabilization of health insurance premiums and other purposes.   States get $8 billion over five years to finance high-risk pools that cover those with pre-existing conditions.

continuous coverage Health insurers must increase premiums by 30% for one year for enrollees who have not maintained  Sec. 133. Continuous health insurance coverage incentive. over the previous year.

  • Consumers who let their coverage lapse for more than 63 days in a year would be charged 30% surcharges to regain insurance. This would include people with pre-existing medical conditions.

The bill amends the Internal Revenue Code to modify premium subsidies and eliminate the subsidies after 2019.

The bill repeals the small employer tax credit  Sec. 204. Small business tax credit.  for employee health insurance expenses, the penalties associated with the individual

and large employer mandates  Sec. 206. Employer mandate.  for minimum essential health coverage, and other PPACA taxes and tax increases.

The bill establishes a refundable tax credit in 2020 for certain taxpayers who purchase health insurance on the individual market.

The bill revises rules for health savings accounts.

State waivers would allow insurers to charge older customers higher premiums by as much as they’d like.  Sec. 135. Change in permissible age variation in health insurance premium rates.  MacArthur Amendment

Repeals taxes on the wealthy, insurers, drug and medical device makers.

Sec. 251. Repeal of net investment income tax.

Sec. 231. Repeal of tanning tax.

Sec. 221. Repeal of tax on prescription medications.
Sec. 222. Repeal of health insurance tax.

Sec. 241. Remuneration from certain insurers.

States get $130 billion over a decade to help people afford coverage.   —  See our page on High Risk Pools  use search engine above

Keeps ACA provision that children can remain on their parents’ insurance plans until age 26. Modern Health Care 5.4.2017     *   Latest iterations? 538.com


Links & Resources

Here’s what we have so far on American Health Care Act  of 2017


The bill would:

–retroactively repeal the ACA’s requirement for most Americans to buy health insurance, individual mandate as of the end of 2015. That may leave insurers wary about offering plans for 2018.

–end enhanced federal funding at the end of 2019 for states to expand Medicaid block grants to low-income adults. Our webpage

–convert Medicaid to a program of capped per-capita federal grants to the states, starting in 2019. Hospital leaders are very nervous about how this would affect uncompensated care and payment levels. Our webpage

–establish age-based, refundable premium tax credits to help people buy insurance, with the credits phasing down starting at income levels of $75,000 for individuals and $150,000 for families. These credits would be adjusted annually by the consumer inflation rate plus 1%.

–starting in 2018, repeal most of the ACA taxes * page 68 Rev. 3.6.2017  that finance the law’s premium subsidies, Medicaid expansion, block grants  and Medicare benefit enhancements.  See our webpage on no taxes

retain the ACA’s so-called Cadillac tax on high-value plans but delay it until 2025 – page 85 3.6.2017 Revision

–eliminate the ACA’s minimum essential benefits at the end of 2019.

–offer states $100 billion over nine years to establish high-risk pools or other mechanisms for stabilizing the individual insurance market.  Page 45 Section 132 Rev 3.6.2017

–mandates (shall) insurers charge individuals who buy insurance after letting their coverage lapse a 30% premium penalty for one year, to encourage people to maintain continuous coverage. Section 133 Rev 3.6.2017 page 61

–allow insurers to charge older customers five times higher premiums than they charge younger people, up from the ACA’s permitted 3 to 1 age differential.  Sec. 135. Change in permissible age variation in health insurance premium rates.

–repeal the ACA’s cut in funding for Medicaid disproportionate share payments, which has not yet taken effect.

repeal the ACA’s subsidy to reduce low-income enrollees’ cost-sharing CSR Cost Sharting Reductions – Enhanced Silver in private health plans, effective at the end of 2019.

 Modern Health Care 3.7.2017 * 3.8.2017 *


Side by Side Comparison New York Times 3.6.2017


Six changes Trump can still make to ACA NPR 3.29.2017 

Child Pages

Published on Feb 25, 2017 Details of potential Obamacare replacements

break down House Republicans’ new health care bill

Summary Chart - GOP Repeal & Replace 3.6.2017
Summary Chart – GOP Repeal & Replace 3.6.2017



AHCA of 2017 Committee Report - 822 Pages
AHCA of 2017 Committee Report – 822 Pages

Nancy Pelosi – “But we have to pass the bill so that you can find out what is in it, away from the fog of controversy.”

SB 562

Ricardo Lara

How To Save Health Care: A Memo to Donald Trump


Will it be Medi-Cal, Medicard for all?




The Middleman from Healthy California on Vimeo Better Than Before from Healthy California on Vimeo.  

excerpt from the documentary "Architecture of Doom." It shows how the Nazis considered the German population as one body to be healed collectively by the German universal healthcare system (Hitlercare).

17 comments on “AHCA passes House HR 1628

  1. Good morning, Steve!

    Hope all is well with you. Just checking in…

    I have been watching/ reading everything I can about the reform issues….It looks rather bleak for people in that ‘no man’s land’ area–senior, but too young for Medicare. I am anticipating a minimum of 20% rate increase, reduced coverage, higher out of pockets, and higher deductible…Which is when I go, ” Is it really worth it?”

    I spent 3 months fighting with BC to get an MRI approved–which they ultimately denied and I ended up paying for myself–just so I could get an epidural for an old neck issue that I had previous epidurals for…

    I question if it is a good business decision to ‘pay for the privilege of contracted rates’, vs. putting that same amount in my own version of a HSA and hoping nothing bad happens…

    I am sure you have been inundated with questions since this whole thing started…

    I just wanted to thank you again for being a resource for me. I cannot thank you enough. Have a lovely day.

    Becky F

  2. What’s the news with Trumpcare – does anyone even know, yet?

    From what I’ve seen, nothing is decided, a bunch of things are being argued or talked about, and California is doing its own thing separate from that – but I don’t know any details.

    • Steve:

      My wife has her Blue Shield individual policy through your agency.

      Just wondering if you’ve heard anything about BSC – Blue Shield of CA intentions for 2018 regarding policy alternatives (will her policy still be available) and premiums.


  3. Hi Steve,

    do you think due to all the political upheaval that my current health insurance policy – Blue Shield Gold PPO will be available next year & if so~will it increase a great deal?

    I’m working on getting as much taken care of this year.

    • Good Question.

      I’m doing my best to monitor the situation on this website. Just watch, wait and see. Here’s a summary as of 5.18.2017 from CA Association of Health Underwriters.

      Be sure to contact your elected representatives too.

      Those in support of AHCA say everything will be better, those against say everything will be worse. I resent so many people saying things and not citing the actual bill or law.

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