House Republican leaders release ACA repeal legislation -AND- What's in the Obamacare replacement bill, anyway? 13 things to know about the ACA repeal bill

Wed Mar 15 13:43:31 PDT 2017

March 7, 2017

House Republican leaders release ACA repeal legislation

<http://news.aha.org/article/170307-house-republican-leaders-release-aca-rep
eal-legislation> American Hospital Association

House Republican leaders last night unveiled a legislative package to repeal
and replace parts of the Affordable Care Act. Taken together, the bills by
the Republican leadership of the Energy & Commerce and Ways & Means
committees - collectively called the American Health Care Act - would repeal
the ACA's employer and individual mandates to purchase health coverage and
replace the law's means-tested advance premium tax credits and cost-sharing
reductions with tax credits that vary by age and income. The package also
would end the enhanced Medicaid federal funding for future expansion
populations, beginning in 2020, and transition the program to a per capita
cap funding model. In addition, the package would repeal most of the law's
taxes while maintaining, though delaying, the tax on high-value
employer-sponsored health plans (or "Cadillac" tax). The bill does not
restore the hospital market basket reductions or Medicare disproportionate
share hospital cuts used to help fund the ACA coverage expansions. "Health
care coverage is vitally important to working Americans and their families,"
said AHA President and CEO Rick Pollack in a letter to members of the House
of Representatives. ".We ask Congress to protect our patients, and find ways
to maintain coverage for as many Americans as possible. We look forward to
continuing to work with the Congress and the Administration on ACA reform,
but we cannot support The American Health Care Act in its current form." AHA
members received a Special Bulletin with highlights of the legislation. 

March 8, 2017

What's in the Obamacare replacement bill, anyway? 13 things to know about
the ACA repeal bill 

<http://www.modernhealthcare.com/article/20170308/BLOG/170309904?utm_source=
modernhealthcare&utm_medium=email&utm_content=20170308-BLOG-170309904&utm_ca
mpaign=financedaily> Modern Healthcare

By Harris Meyer

House Republicans released a bill on March 6 that would repeal and replace
the Affordable Care Act. The 123-page bill, named the American Health Care
Act, includes major changes to healthcare in the nation. Here's a rundown of
some key components of the law to track as markups take place this week:

1. Retroactively repeals mandatory health insurance: It would repeal the
ACA's tax penalty on Americans who have not purchased health insurance as of
2016. This could shake up insurers' plans for setting rates in 2018.

2. Gives Medicaid a facelift: The program would convert to a system of
capped per-capita federal grants to the states starting in 2020. Watch out,
hospitals-this could affect uncompensated care and payment levels.

3. Phases out Medicaid state expansion: States would lose enhanced federal
funding for new Medicaid expansion enrollees at the end of 2019.

4. Establishes new premium tax credits: The age-based, refundable credits
would help people buy insurance. The credits start phasing out for
individuals with incomes of $75,000 and families at an income level of
$150,000. Credits would adjust annually by the consumer inflation rate plus
1%.

5. Repeals most ACA taxes in 2018: The bill would eliminate most taxes that
finance the law's subsidies, Medicaid expansion and Medicare benefit
enhancements.

6. Preserves, yet delays the Cadillac tax: The ACA's so-called Cadillac tax
on high-value plans will stay, but it's delayed until 2025.

7. Nixes minimum essential benefits in Medicaid managed care: The bill
eliminates the requirement for Medicaid managed-care plans to cover minimum
essential benefits by the end of 2019. The rules stay in place for private
insurance.

8. Encourages high-risk pool funding: The bill offers states $100 billion
over nine years to establish high-risk pools or other solutions for
stabilizing the individual insurance market.

9. Establishes a continuous coverage penalty: Insurers can charge a
one-year, 30% premium penalty to individuals who let their insurance
coverage lapse and want to enroll in a plan.

10. Increases costs for older insurance customers: Insurers can charge older
customers five times higher premiums than they charge younger customers-this
rate is raised from the ACA's 3-to-1 age ratio.

11. Revives disproportionate-share payments: The bill would repeal the ACA's
proposed cuts to Medicaid disproportionate-share payments. The reductions
have not gone into effect.

12. Cuts low-income enrollee subsidies: The ACA's subsidy to reduce
low-income enrollees' cost-sharing in private health plans would disappear,
effective at the end of 2019.

13. Reduces support to organizations performing abortions: The bill would
prohibit Medicaid funding for Planned Parenthood and other organizations
that perform abortions. It also prohibits using tax credits to purchase a
health plan that would cover abortions.

Jeff Wells
Deputy Editor, CAL/AAEM News Service

Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

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