The American Health Care Act, referred to by the acronym AHCA, and occasionally referred to as "Trumpcare," is a proposed United States Congress bill whose initial contents were publicly released by House Republicans on March 6, 2017. The AHCA is intended to be a replacement for the Patient Protection and Affordable Care Act (commonly shortened to ACA, and referred to as "Obamacare") enacted in 2010 under the Obama administration. The draft bill is a combination of legislative recommendations that were passed by the House Energy and Commerce Committee and the House Ways and Means Committee on March 9, 2017. It will be considered by the Budget Committee on March 16, 2017 before reaching the House floor.
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The non-partisan Congressional Budget Office released its score (analysis) of the bill on March 13, 2017, concluding that:[12][13]
Persons with healthcare insurance coverage would be reduced by 14 million in 2018, 21 million in 2020, and 24 million in 2026 relative to current law.
The AHCA would reduce the deficit relative to current law by $337 billion over a decade. Approximately $1.2 trillion less would be spent over that time, while $900 billion less in tax revenue would be collected. Medicaid spending would be cut considerably. Taxes on the roughly top 5% of income-earners under current law would considerably drop.
Insurance premiums would rise initially relative to current law, but would be reduced in the future moderately: "Starting in 2020, the increase in average premiums from repealing the individual mandate penalties would be more than offset by the combination of several factors that would decrease those premiums: grants to states from the Patient and State Stability Fund (which CBO and JCT expect to largely be used by states to limit the costs to insurers of enrollees with very high claims); the elimination of the requirement for insurers to offer plans covering certain percentages of the cost of covered benefits; and a younger mix of enrollees. By 2026, average premiums for single policyholders in the nongroup market under the legislation would be roughly 10 percent lower than under current law..."
Premium changes would vary significantly by age: "Under the legislation, insurers would be allowed to generally charge five times more for older enrollees than younger ones rather than three times more as under current law, substantially reducing premiums for young adults and substantially raising premiums for older people." This would lead to a mix of younger enrollees, one of the reasons for the lower overall premiums over the longer-term.
Under both current law and the AHCA, CBO assumes the health exchange marketplaces would remain stable (i.e., no "death spiral").[12]
Social Security expenditures would decrease due to earlier mortality: "CBO also estimates that outlays for Social Security benefits would decrease by about $3 billion over the 2017-2026 period."
Medicaid expenditures would increase due to reduced access to birth control. "By CBO's estimates, in the one-year period in which federal funds for Planned Parenthood would be prohibited under the legislation, the number of births in the Medicaid program would increase by several thousand, increasing direct spending for Medicaid by $21 million in 2017 and by $77 million over the 2017-2026 period."
[th][/th] [th]ACA[/th] [th]AHCA[/th] | |||||||||||||||||||||||||||||
[th]Insurance mandates[/th]
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