Trump Care virtually Dead
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
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.
- Replaces the ACA’s cost sharing subsidies based mostly on consumers’ incomes and premium costs with tax credits that grow with age. Sec. 135. Change in permissible age variation in health insurance premium rates.
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.
- Ends the tax penalty against people without coverage. Sec. 205. Individual mandate.
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.
States get $130 billion over a decade to help people afford coverage. — See our page on High Risk Pools use search engine above
|Published on Feb 25, 2017 Details of potential Obamacare replacements||break down House Republicans’ new health care bill|
|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.”|
Links & Resources
Here’s what we have so far on American Health Care Act of 2017
- HR 1628 Congress.Gov
- House Republication Website – American Health Care Act
- Summary Energy Commerce.House.gov
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.
–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
–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.
Side by Side Comparison New York Times 3.6.2017
Six changes Trump can still make to ACA NPR 3.29.2017
- Stop the Enhanced Silver – Cost Sharing Reductions
- No enforcement of Mandate Tax Penalty
- Loosen the Definition of Essential Health Benefits
- No sales follow up – if someone gets a quote on this website, they get a dozen emails over the next few months. HealthCare.Gov wouldn’t. Covered CA probably will. No charge for us to help you enroll and consult!
- AHCA – American Health Care Act of 2017 – Leaked early version
- Breaking News – AHCA
- Budget Committee & Covered CA Report – AHCA 2017 HR 1628
- Opposition to AHCA
- Senate Version HR 1628
- Side by Side Comparison ACA vs House AHCA