Breaking Down the House ACA Repeal and Replace Legislation
Posted March, 7 2017 by Taylor Frazier
Yesterday, Members of the House of Representatives introduced Affordable Care Act (ACA) repeal and replacement legislation in the Ways and Means and Energy and Commerce Committees. According to a blog post from Health Affairs, the committees will begin markup of the bills tomorrow, March 8, and the House is hoping to pass a repeal and replacement bill in the next three weeks.
The two bills would not repeal the ACA entirely. They would leave in place many of the ACA’s insurance reforms including: coverage for people with pre-existing conditions; guaranteed availability of coverage; coverage of young adult children under their parents’ health plans until age 26; and annual out-of-pocket maximums. The bills would also leave in place certain consumer protections including the ban on discrimination on the basis of race, nationality, disability, age, or sex.
However, there are a number of provisions in the two bills that would harm consumers. These include:
- Medicaid would be transitioned to a per capita cap program by 2020. This means that the federal government would provide a fixed amount of money to each state per enrollee, rather than a percentage of the total costs per enrollee.
- Federal funding for Medicaid expansion would be eliminated.
- States would be provided incentives to re-determine Medicaid eligibility more frequently. In New York, many Medicaid enrollees have 12-month continuous Medicaid coverage.
Undermining Coverage Gains
- Individuals would no longer face a tax penalty for not having coverage. Instead, premiums would go up by 30 percent as a penalty for consumers who do not maintain continuous coverage during the 12 months preceding enrollment in a new plan.
- Employers would no longer be penalized for not offering coverage to their employees and dependents.
Eroding Marketplace Affordability
- States would be allowed to charge older consumers premiums 5 times greater than those of younger consumers. Currently, insurers are only allowed to charge only consumers 3 times as much as younger consumers.
- The current income-based advanced premium tax credits would be replaced with tax credits based on age. This means that a low-income consumer would receive the same tax credit as a wealthy consumer in the same age bracket.
- Cost-sharing reductions for eligible consumers with incomes under 250 percent of the Federal Poverty Level would be eliminated after 2019.
- Plans sold through the Marketplace would provide less coverage for health services, and consumers would be responsible for more out-of-pocket costs.
Reducing Access to Family Planning Services
- Planned Parenthood would lose federal funding for one year if the bills become law.
New York Representatives Chris Collins and Paul Tonko serve on the Energy and Commerce Committee, and Representatives Tom Reed and Joe Crowley serve on the Ways and Means Committee. If you or someone you know would be affected by the changes proposed in these two bills, please call your elected Representatives today at 1-866-426-2631.