the bill was pulled from the House floor.
1. March 6: House Republicans unveiled the AHCA.
2. March 8: The House Energy and
Commerce and Ways and Means
Committees both pass separate legislation to repeal and replace the ACA.
3. March 13: the Congressional Budget
Committee released its report estimating that AHCA would lower the
deficit by $337 billion over the next
decade, but that 24 million more
people would be uninsured by 2026.
4. March 16: The House Budget Committee combines and passes the
House Energy and Commerce, and
Ways and Means Committee ACA
repeal and replace bill.
5. March 22: The House Rules Committee passes a modified version of the
previous bills, clearing the way for a
final House vote.
6. March 23: House leaders fail to garner enough votes to pass AHCA, symbolically on the seventh anniversary
the Affordable Care Act was passed.
With the encouragement of President
Donald J. Trump, Speaker Paul Ryan
delays the vote until Friday.
7. March 24: After meeting with President Trump at the White House for
an hour, Speaker Ryan returns to
Capitol Hill and announces that he
was pulling the bill from the floor,
effectively postponing a future vote
for an unspecified period of time.
8. May 3: After introduction of MacArthur and Upton Amendments, the
House announced another vote on
What Happens Next?
Since pulling the bill on March 24,
GOP centrists— called the “Tuesday
Group”— and the conservative House
Freedom Caucus reached an agree-
ment on an amendment. While states
would still have the ability to opt out of
some federal insurance standards, this
proposes that states would have to at-
test that their purpose in waiving these
high-risk pool coverage or participate
in the federal pool.
In an effort to secure more moder-
ate votes, Rep. Fred Upton (R-Mich.)
Provision ACA AHCA
Individuals who purchase insurance
through the health insurance exchanges
and make < $48,000 a year are eligible for
federal subsidies. Subsidies are based on
a person’s income and the relative cost
of insurance in their area. Subsidies are
automatically applied to insurance bills
through direct payment from federal
government to insurer.
Insurance subsidies in the form
of tax credits will be tied to a
person’s age rather than income.
People under 30 are eligible for a
credit of $2,000, while people over
60 would be eligible for $4,000. A
new fund is established to provide
approximately $85 billion in tax
assistance due to high premiums
for individuals age 50 to 64.
Individuals are required to obtain ACA
compliant health insurance or face an
annual tax penalty (unless exempted).
No tax penalty. Individuals will face
a continuous coverage surcharge
of 30% if they go longer than two
months without insurance and buy
a new insurance plan.
Large companies are required to provide
health insurance to their employees or
face financial penalties.
This provision is repealed.
Young Adults Young people can stay on their parents’
health insurance plans until the age of
Insurers are required to offer 10 essential
health benefits in all ACA-compliant
States establish their own standards
for essential health benefits
beginning in 2018.
on Annual and
Insurers cannot set a limit on how much
they have to pay to cover someone.
Insurers can charge elderly customers no
more than three times what they charge
Insurers can charge elderly
customers up to five times what
they charge young adults.
Establishes a permanent Risk
Adjustment program that transfers
money between insurers based on the
risk levels of their enrollees.
Establishes $100B state innovation
fund to establish programs, such as
reinsurance or high risk pools that
will provide or subsidize health care
for high risk individuals.
States can expand Medicaid coverage for
low-income individuals by expanding the
eligibility cutoff to 138% of the poverty
level (about $16,640 for an individual).
Currently, 31 states have chosen to
expand Medicaid coverage.
Medicaid expansion sunsets
in 2020. Coverage of Medicaid
expansion populations would not
be subject to meeting “essential
health benefits” requirements.
Additional states are immediately
prohibited from expanding
Medicaid, and Medicaid enrollment
at ACA payment rates will be
frozen at the end of 2019.
Table 1. Affordable Care Act vs American Health Care Act
insurance regulations is to reduce the
cost of health care or to increase the
number of people with health coverage.
States would also be required to offer
Source: Compare Proposals to Replace The Affordable Care Act. The Henry J. Kaiser Family