Yesterday, House Ways and Means Chairman Kevin Brady (R-TX) and House Energy and Commerce Committee Chairman (R-OR) Greg Walden released their committee’s legislative contributions to the American Health Care Act, the long-awaited Republican proposal to repeal and replace the Affordable Care Act (ACA), also known as Obamacare.
The plan includes repeal of the individual mandate to purchase health insurance and would instead be replaced with a one-year, 30 percent surcharge on insurance premiums for anyone who has allowed coverage to lapse and attempts to repurchase a health insurance plan. The legislative measures would also dismantle other core provisions of the ACA, including the current subsidies to help people buy coverage, expansion of Medicaid, and many of the taxes levied to help support the law’s infrastructure. The current tax subsidies provided to small employers, including nonprofit employers, to help offset the cost of providing insurance for their employees would also be eliminated.
The new system would instead include graduated tax credit scale for individuals based on age to help individuals buy insurance.
However, the legislation falls short of full repeal touted by many Republicans during the 2016 election season and at the beginning of the year. Protections for people with pre-existing conditions would largely remain in place, as well as the provision that allows children to remain on their parent’s health plans until age 26.
While the Ways and Means and Energy and Commerce Committees are expected to take up and approve legislative language to move the measures to the House floor this week, obstacles remain in the way of final passage. Some of the more conservative House members have expressed concern that the tax credit system would create a “new entitlement.” Meanwhile, at least four Senate Republicans whose states have supported Medicaid expansion under the ACA have said it will be difficult for them to back a bill that cuts back on that core program.
The first step of releasing legislative language may be the easiest as a lot of work remains before the American Health Care Act will be ready for the president’s signature. It remains unclear how much this legislation would cost or how many people would potentially lose or gain access to health coverage.
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Jamie Tucker is the director, public policy strategy and operations at Independent Sector.
