Two house committees began marking up the American Health Care Act Wednesday. The GOP House leadership’s broad plan to repeal and replace Barack Obama’s Affordable Care Act (ACA) was released Monday, and is being reviewed by the Ways and Means and Energy and Commerce Committees.
Conservatives have already argued the plan is too similar to the ACA; doctors and other providers have expressed concern over patients losing health care coverage due to higher costs, and called for lawmakers to reconsider the changes to Medicaid. The proposed plan allows insurers to charge older customers up to five times more than their younger counterparts, a big change from the 3-to-1 rate under the ACA.
The biggest changes in the new plan include eliminating the requirement that most Americans carry health insurance or pay a fine. It would also eliminate the ACA mandate that employers with 50 or more full-time workers must offer health coverage or pay a fine. This repeal would be retroactive to December 31, 2015, allowing employers who failed to provide health insurance coverage last year to avoid the penalty when filing their April tax returns.
The new plan also eliminates tax increases on the wealthy, and returns Health Savings Accounts (HSAs) and Flexible Savings Accounts (FSAs) to their pre-ACA status (the plan proposes to nearly double the current allowable contribution levels for HSAs).
The proposal does keep some popular provisions, and though Republicans control both Congress and the White House, it is not certain the plan will become law.
It is also unclear how much this new proposal will cost or how many Americans could gain or lose coverage under the new terms. The bill proposes replacing ACA tax credits used to lower premiums with new, more flexible tax credits for individuals who earn up to $75,000 and households up to $150,000.
The Energy and Commerce Committee will take on Medicaid and non-tax issues while the Ways and Means Committee works on the tax-related issues. The new plan would significantly affect the way the Medicaid system is funded.
The bill would also repeal the authority of states to expand their Medicaid programs, cap the amount on federal funding a state will receive per person for its Medicaid program and stop federal funding for Planned Parenthood.
Democrats have pushed back on the plan, calling it a “betrayal of everyday Americans,” and say they have no intention of working with Republicans on moving it forward. In particular, the plan to eliminate funding for Planned Parenthood has generated fierce disapproval from Democrats and some Republicans, who argue that federal funds are already barred from funding abortions, and eliminating funding for Planned Parenthood would simply hinder millions of American women from getting routine medical care.