House Republicans have revised the American Health Care Act, which is proposed to repeal and replace the Affordable Care Act. Essentially, the changes made will delegate more Medicaid responsibility to the states, easing some tax requirements, improving (over the original bill) coverage and access for older Americans, and eliminating any tax dollars or credits to be used for abortions. An adjusted CBO score also is expected to be released reflecting these changes.
Three House Committees–Energy and Commerce, Ways and Means, and Budget–collaboratively amended the AHCA to “ensure more Americans have access to quality, and affordable health care,” according to the department of Energy and Commerce Committee statement. Energy and Commerce Committee Chairman Greg Walden, R-Ore., and Ways and Means Committee Chairman Kevin Brady, R-Texas, introduced technical and policy amendments to the measure.
“Our legislation includes ideas from Republican members who are committed to improving health care for patients and families across the country,” Walden and Brady said. “We look forward to working with our Senate colleagues to get this bill over the finish line and send it to the President as quickly as possible. President Trump deserves tremendous credit for rolling up his sleeves and working tirelessly to deliver on his healthcare promise to the American people.”
Hunter Howard, founder of Dallas-based Hormone Therapeutics and other healthcare startups, told D CEO Healthcare that, after spending two days of meetings on Capitol Hill with seven congressmen and 45 healthcare CEOs from around the country, it seems the AHCA will be successful after its alterations.
“They see the successful AHCA rollout in three prongs, where [first] they just need a simple 51 percent majority through the budget reconciliation process for program elements touching the budget like Medicaid expansion,” Howard said. “Phase II covers 1,300 ACA elements the HHS Secretary Tom Price can directly alter; Phase III will require bipartisan voting support and focus on tort reform, cross-state line insurance purchasing, and price transparency. The team aims to accomplish all three phases in 2017. True success will not come without all three phases.”
The Energy and Commerce Committee reported that, under its jurisdiction, the AHCA amendment would execute the following:
Give states additional flexibility for their Medicaid programs.
This amendment would allow states to have another option instead of the per-capita allotment baseline. States can receive federal funds through a block grant that applies to children and adult Medicaid populations, with funding for elderly and disabled populations calculated through a per-capita allotment. After 10 years, states can revisit their baseline options.
Give states the ability to implement optional work requirements for their Medicaid programs.
This amendment allows states the flexibility to implement reasonable work requirements for able-bodied adults without dependents. The requirements fall in line with the Temporary Assistance for Needy Families program, which involves employment, vocational or skills training, education in pursuit of employment, and community service, among other things.
Freeze and unwind Obamacare’s Medicaid expansion.
The AHCA’s amendment would prevent new states from participating in Medicaid expansion. The bill allows beneficiaries who enroll before Dec. 31, 2019, to be “grandfathered” into the program, ensuring states will continue to receive the enhanced funding levels, as long as those individuals remain in the program.
Provide a more generous reimbursement for elderly and disabled Medicaid enrollees.
The amendment would increase the annual inflation rate for elderly and disabled Medicaid populations.
Under the Ways and Means Committee’s jurisdiction, the amendment would:
Provide relief from ACA taxes.
AHCA plans to dismantle ACA taxes and mandate penalties. This amendment would accelerate repealing ACA taxes to 2017, so individuals who were penalized can reclaim money from the IRS. The bill also provides the maximum relief possible from the Cadillac tax, given the rules of the Senate.
Ensure Americans have access to appropriate care.
Currently, Americans can deduct from their taxes the cost of medical expenses that exceed 10 percent of their income. The AHCA amendment reduces the threshold to 5.8 percent of income in order to give the Senate flexibility to enhance the tax credit for people aged 50 to 64 needing additional assistance.
Protect life by prohibiting taxpayer dollars from being used for abortion services.
The AHCA will prohibit taxpayer funds from being used for abortion coverage and abortion procedures. This amendment only allows individuals to use federally funded tax credit to purchase insurance plans that do not cover abortions or abortion services.