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What’s in the House version of AHCA?

Here’s the quick summary of the Republican bill. Lots of details here.

Net is the bill attempts to give states much more leeway in establishing and regulating health insurance policies and programs – sort of returning to the world we had pre-ACA.

While the bill was passed without a CBO evaluation/score, it is similar enough to the original bill. My guess is we could expect at least 15 million people will lose insurance coverage under this bill…but remember it’s not going to pass the Senate.

  • It replaces income-based subsidies (basing financial subsidies on a person’s income) with age-adjusted tax credits of fixed amounts.
    This means – wealthy and near-poor people of the same age get the same $ amount
  • Eliminates the individual and employer mandate
    This means – no requirement that people have health insurance.
  • Increases premiums for older people and reduces them for younger folks who get their insurance from small employers or in the individual market
    This means – more young people may sign up, more older folks will find insurance unaffordable
  • Ends funding for Medicaid expansion and caps future federal Medicaid payments
    This means – fewer low-income people will have coverage, states will have to come up with more money.
  • Penalizes individuals and families that don’t maintain continuous insurance coverage
  • Allows states to let insurers drop coverage for different types of medical care
    This means – consumers may not be able to get coverage for their condition or the type of care they need (e.g. drugs, behavioral health, maternity)
  • Eliminates taxes and tax increases from ACA
    This means – Medicare will run out of money in a couple of years instead of 10+

This is just what’s in the actual bill – which is already under fire by Senate Republicans; Portman, Heller, Graham, Scott, and Snowe have all voiced objections.

Instead of adopting or modifying the House Bill, expect an entirely new bill from the Senate. If the Senate bill is passed (which may – or may not – require 60 votes), then the House and Senate will have to figure out how to move forward and which bill is the vehicle.



6 thoughts on “What’s in the House version of AHCA?”

  1. Providing States with more regulatory authority to handle heath care programs is a positive. We’ll have to wait to see what the Senate Legislation looks like.

    1. Hello Brad – welcome to MCM.

      Of course, the Rs seem to only want states to have the “regulatory authority” they want them to have. For example, all plans in NY and CA must cover abortion, however AHCA prohibits use of tax credits or subsidies for any plans that offer abortions. period.

      Hypocrisy reigns.

  2. You said it was dead in the house. I hope you are correct that it wont pass the senate.

    1. Hi JG – thanks for the note – I should have been clearer in the original post that this wasn’t going to get out of Congress in anything like the form it is in today. So we’ll split the difference.

  3. I voted for Trump but this is a DUMB Idea. I am a Senior in my 70’s with no income but my Social Security & have not been able to afford any secondary insurance so only have Medicare. PLEASE DO NOT take that Coverage Away. PLEASE PLEASE DON’T MESS With Social Security or Medicare.

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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