What Is the the American Health Care Act?


On Monday, House Republicans shared their long-anticipated replacement plan to the Affordable Care Act (ACA), also known as Obamacare: the American Health Care Act (AHCA). While Republicans have promised they would repeal Obamacare since its inception seven years ago, this is the first plan they have released as a party. (Before the AHCA, Rep. Paul Ryan (R-WI) and Health and Human Services Secretary Tom Price had released their own plans for replacing the ACA.)

The Republican’s new plan will keep many aspects of Obamacare – partly due to the way the Republicans plan to push the bill through Congress, the budget reconciliation process, which lets Congress repeal parts of the bill related to spending and taxes. Unlike standard voting measures, the budget reconciliation process prohibits filibustering and only requires a simple majority (51 votes) for a bill to pass.

If both houses can pass the bill with a simple majority (and with a Republican majority in both the House and Senate, they easily can), the bill moves to President Trump’s desk for his signature. On Tuesday, the Trump administration signaled its support for the new bill, according to The Hill.

Voting for the 123-page bill starts on Wednesday, leaving Americans little time to fully understand what the bill changes and what it keeps. To help simplify things, we’ve answered some frequently asked questions.

I have a preexisting condition. Will insurers be allowed to deny me coverage? 

No, under the AHCA, ACA protections for people with preexisting conditions will remain in place. This means insurers cannot deny you coverage based on preexisting conditions and cannot place a lifetime cap on your care. Insurers are also prohibited from charging you more based on your illness or disability.

However, if you lose coverage – say you lose your employer-based insurance plan and you go without insurance for more than 63 days – insurers can increase your premiums by 30 percent, and you would be required to pay this increased rate for one year before returning to the standard rate. This provision applies to everyone, not just those with preexisting conditions, Vox reports.

My child is on my health insurance plan. How long will they be able to stay on my plan? 

Like with Obamacare, the AHCA lets children stay on their parents’ or guardians’ health insurance plan until they are 26.

Will those without health insurance be fined if they do not purchase a plan? 

Under Obamacare’s individual mandate, those without health insurance were fined for going without coverage. The AHCA would remove the individual mandate as well as Obamacare’s employer mandate, which requires large companies to provide their employees with health insurance.

I receive subsidies under Obamacare. Will I get to keep those? 

That depends on what kind of subsidies you receive. If you receive subsidies to help you cover the cost of your deductibles and co-pays, those subsidies will be repealed starting in 2020. If you receive income-based subsidies to help pay your premiums, those will remain, but the way they are doled out will change. Now, instead of tax credits based purely on income, tax credits will be distributed with more consideration given to age. Those who earn less than $75,000, be it $24,000 or $72,000, would get the same amount of help. If you earn more than $75,000, your tax credits would be based on age, with people under the age of 30 receiving $2,000 a year and those above the age of 60 getting $4,000.

I’m an older American. Can insurers charge me more for my plan?

Yes, even through Obamacare insurers could charge older Americans more for health insurance — three times the rate younger people pay. Under the AHCA, insurers would be able to charge older Americans five times the rate they do younger people. States would also be able to set their own ratio, meaning insurers could potentially charge more or less.

Can I buy insurance across state line now? 

As of now, no. Though Trump campaigned with the promise to make health insurance purchasable across state lines, this provision was not included in the GOP’s replacement plan. However, on Tuesday, Trump tweeted, “Don’t worry, getting rid of state lines, which will promote competition, will be in phase 2 & 3 of healthcare rollout. @foxandfriends.”

I’m covered under the Medicaid expansion. Will I lose my coverage? 

Not necessarily. States that opted into the Medicaid expansion will continue to receive federal funding until 2020. After 2020, the program will be frozen, meaning those who are newly eligible or leave the program and want to come back will receive less federal funding. Per the New York Times, the bill also proposes capping federal funding per enrollee, rather than previous Medicaid plans which reimbursed states fully, based on how much states spent in 2016.

Will this affect my health savings account (HSA) at all?

Yes, under the AHCA you will now be able to put more money into your HSA. Starting in 2018, individuals will be able to contribute $6,550, up from $3,400, into their account and families $13,100, up from $6,750.

Have a question you’d like answered? Let us know in the comments below. This article will be updated as more questions and information come in. 

Photo Credit: Angela N. 


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