In perhaps the most anticipated legislative act since November's contentious election, House Republicans today proposed a replacement for the Affordable Care Act (ACA).
Dubbed the American Health Care Act, the new proposal would eliminate the individual mandate that imposes a tax penalty on Americans without heath insurance. Some of the restrictions regarding pre-existing conditions would remain, as would the provision to grant coverage for dependents until the age of 26. Certain refundable tax credits that exist under the ACA would stay in place for families with incomes lower than $14,000.
Republicans hope the new bill will pass Congress within the next 30 days.
Additionally, age-based credits would be built into the bill, starting at $2,000 for those under age 30 and reaching $4,000 for those over 60. The maximum per household credit will be $14,000.
“The American Health Care Act is a plan to drive down costs, encourage competition, and give every American access to quality, affordable health insurance,” House Speaker Paul Ryan (R-WI), said in a statement. “It protects young adults, patients with pre-existing conditions, and provides a stable transition so that no one has the rug pulled out from under them.”
In addition to repealing a number of ACA-related taxes, other changes in the bill focus on health savings account expansions, a per capita allotment for states, a patient and state stability fund of $100 billion, and continued tax credits to help pay for insurance, including the age-based incentives. These new tax credits would be phased out for individuals making more than $75,000 and for families making more than $150,000.
The new bill also repeals the employer mandate, which imposes a fee on companies with more than 50 employees if they do not provide insurance for at least 95% of full time employees. The removal of the individual and employer mandates would take effect retroactively for the 2016 calendar year.
“Obamacare is rapidly collapsing. Skyrocketing premiums, soaring deductibles, and dwindling choices are not what the people were promised seven years ago,” Ryan said. “It’s time to turn a page and rescue our health care system from this disastrous law.”
The announcement of the American Health Care Act drew criticism from Democrats. In a statement, Nancy Pelosi (CA-D) mocked the proposal, calling it the “Make America Sick Again” bill.
“Tonight, Republicans revealed a Make America Sick Again bill that hands billionaires a massive new tax break while shifting huge costs and burdens onto working families across America,” said Pelosi. “Under the Republican bill, older Americans will be exposed to soaring new costs, and millions of families will lose their health coverage. The GOP bill shortens the life of the Medicare Trust Fund and pushes millions of seniors and disabled Americans who depend on Medicaid coverage into the cold.”
Elements of the bill had been in discussion since late February, when what appeared to be an early draft made its way to the press. That also included the age-based credits, which drew criticism for being insufficient. Republicans may argue increased competition and lower costs could stretch those credits further.
The call to repeal the ACA and replace it with a different set of legislature has echoed through the halls of Congress since the act was signed. In his first Executive Order while in office, President Donald J. Trump called for a “prompt repeal” of the ACA. Prior to the Executive Order, Congress passed a budget resolution to defund part of the ACA. The Senate passed to budget change in a vote of 51-48 and the House voted 227-198. This resolution was passed as a “budget reconciliation,” to avoid filibuster, which is a similar tactic used to introduce the American Health Care Act.
Before becoming law, the American Health Care Act will still need to pass a vote from the House of Representatives and Senate before ultimately being signed by President Trump.