House Introduces American Health Care Act to Repeal Obamacare
March 9, 2017
AGA is monitoring the process to ensure that patients have access to quality health care.
House Republican leadership introduced the American Health Care Act — legislation that repeals the Affordable Care Act (ACA) — making good on the Republican’s promise to repeal and replace the current health-care law. Both the House Ways and Means Committee and the Energy and Commerce Committee held concurrent mark-ups on the legislation, since both committees have jurisdiction over the health-care law.
The committees are using the budget reconciliation process to repeal the legislation, which only requires a simple majority in the Senate and will prevent the legislation from being filibustered. However, the Congressional Budget Office has not scored the legislation, so members do not know how much repealing the legislation will cost or how many people it will insure. Republicans decided to move the process forward without a score despite opposition from Democrats. The reconciliation process only addresses those provisions that require government revenue or spending and not policy issues, which will be addressed at a later date.
Key Provisions of the American Health Care Act
- Individual mandate that requires individuals to purchase insurance or face a penalty.
- Employer mandate that requires employers to provide health insurance to their employees.
- Subsidies to help people buy insurance and replaces them with tax credits tied to age to help purchase insurance. People under 30 would be eligible for a $2,000 tax credit, increasing to $4,000 for those over 60.
- 3.8 percent investment tax on investment income and a 0.9 percent tax on wages for the highest earning incomes.
- Medical device tax.
- Encourages people to buy insurance by penalizing those who go 63 days or longer without continuous coverage. They would pay a 30 percent higher premium when they buy insurance.
- Freezes Medicaid expansion in 2020 and changes the way the federal government funds Medicaid to the states by capping states based on how many people are enrolled.
The legislation keeps several provisions from the ACA, such as preventing discrimination of pre-existing conditions, elimination of lifetime caps on insurance, and allowing children to remain on their parents’ health insurance until age 26.
AGA is closely monitoring the process to ensure that patients are still able to receive coverage for preventive screenings without cost-sharing, such as colorectal cancer screenings, and we continue to advocate that this section remain. We are concerned that patients who received coverage through the ACA will lose coverage and that patients will not have access to specialty care. A repeal will result in millions of patients being uninsured and millions of dollars in uncompensated care to providers like gastroenterologists. We will continue to monitor the legislative process and voice our concerns. Learn more about how you can get involved through the AGA Political Action Committee.
Both committees are expected to pass their provisions of the American Health Care Act. House Speaker Paul Ryan has stated that the House plans to pass the bill prior to the April recess. He guaranteed that he would have the 218 votes necessary for passage despite opposition from members of the more conservative House Freedom Caucus to the new health-care legislation. Freedom Caucus members have stated that they are opposed to tax credits and the 30 percent penalty that replaces the individual mandate since they believe this program is a new entitlement.
The American Medical Association and the American Hospital Association, two of the largest health care organizations, have expressed opposition to the repeal bill. It is uncertain whether their opposition will impact the vote in the House but may have more sway when the Senate takes up this legislation.
Once the Republicans pass this part of reconciliation, they will address other provisions of the ACA that are not germane to the budget process, such as repealing the Independent Payment Advisory Board.