HORAN Health Benefits Compliance Blog

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Congress Moves One Step Closer to Repealing and Replacing the Affordable Care Act

 May 4 2017     Diane Cross

Earlier today, the House of Representatives voted (217-213) to pass the American Health Care Act (AHCA), a bill that repeals and replaces many facets of the Affordable Care Act (ACA). For more information on the AHCA, see our previous blog post.   

The AHCA was originally pulled from voting consideration in late March, lacking support from Republicans in the House.  Since then, the GOP has submitted key amendments to help gain the necessary backing for the bill.  One of those amendments, the MacArthur Amendment, grants states more market flexibility by giving them the ability to apply for waivers to forego certain federal rules, such as essential health benefits and pre-existing condition provisions.  Should a state choose to apply for such waiver (which is approved by default), this means that states would have the authority to define essential health benefits and that insurers would potentially have the ability to charge high risk individuals increased premiums.  This does not mean that high risk individuals will be left without coverage opportunities altogether.  A second amendment, the Upton Amendment provides $8 billion over five years to provide assistance to states to reduce premiums or other out-of-pocket costs for people with pre-existing conditions through high risk pools or other means in states that get waivers from ACA pricing rules.  If the AHCA becomes a law, these provisions will become effective January 1, 2020. 

What does this mean for the employee benefits industry? In the immediate – the ACA still remains law of the land.  In order for the AHCA to be signed into law by President Trump it must first be passed by the Senate, which is no small feat. 

HORAN will continue to monitor and report Congress’ progress in the efforts to repeal and replace the ACA.  Please expect that there will be more to come.