House Passes Health Care Repeal Bill

May 10, 2017

On May 4, the House narrowly passed a controversial bill to overhaul the nation’s health-care system by a vote of 217 to 213, however, the measure faces an uncertain future in the closely divided Senate.

The American Health Care Act (AHCA), which repeals and replaces key parts of the Affordable Care Act (ACA) was opposed by twenty Republicans and all House Democrats. Specifically, the House bill gets rid of the individual mandate imposed by the ACA. Instead of the ACA subsidies that are tied to income and premiums, the AHCA plan would provide Americans with refundable tax credits based mainly on age to purchase health insurance.

Among the bill’s more contentious provisions is one that would allow states to let insurers return to their old practice of charging more to customers with preexisting medical problems — a practice that the current law prohibits. Specifically, it would allow states to relax some key ACA protections of those with preexisting conditions, by allowing states to apply for waivers to allow insurers to offer sparser policies that don’t cover the 10 essential health benefits mandated by the ACA. Also, insurers would be able to charge higher premiums to those with medical issues if they let their coverage lapse. States requesting waivers would have to set up programs — such as high-risk pools — to protect insurers from high-cost patients.

An eleventh-hour amendment that helped seal the missing Republican votes would add $8 billion over five years to fund high-risk pools and go toward patients with preexisting conditions in states that seek waivers under the Republican legislation. The legislation already included $130 billion in the fund.

The House passed bill faces an uncertain future in the Senate, where Republicans have a narrow majority and several members have suggested they will develop their own plans. As the Senate begins to wrestle with a Republican healthcare bill, Senate Majority Leader Mitch McConnell (R-Ky.) has established a 13-member working group focused on passing legislation to repeal and replace the ACA. Meanwhile, Democrats are united in opposition to the House bill.