House Republicans released a bill they said will repeal the ACA, called the American Health Care Act (AHCA). It keeps intact some of the more popular features of the ACA, like staying on your parents’ plan until age 26 and ensuring people with pre-existing conditions will have access to insurance. Their plan did not include an estimate from the Congressional Budget Office on how much the proposal will cost or the number of people that would gain or lose coverage. But there are 5 major changes in how people would choose and pay for health care and insurance.
First, tax credits to help buy health insurance would be based on age instead of income and won’t vary by location.
Second, Medicaid federal funding would be rolled back for expansion states in 2020. People who are currently covered now under expansion would continue to be by the federal government but states could not enroll anyone else under the expansion criteria. Also, the federal funding match would be changed to per capita caps based on number of enrollees.
Third, there would be help for wealthier people by repealing almost all taxes increased by the ACA to pay for expansion. There would also be new tax advantages for those who can afford to save.
Fourth, the mandates to buy or provide coverage penalties would be reduced to zero, rendering them moot. There would be a penalty instead for those who don’t retain “continuous coverage.”
And fifth, how the AHCA will be paid for. It is not clear right now from the plan, but the Republican fact sheet said they are “committed to replacing with fiscally responsible policies that restore the free market and protect taxpayers.”