KUSA - After spending the better part of the last two years investigating health care costs, 9Wants to Know decided we needed to read all 123 pages of the American Health Care Act, the proposed repeal and replacement of the Patient Protection and Affordable Care Act of 2009, to find out what is in it.
To help you through it, we’ve created a table of contents with annotations to help you find the parts you are the most curious about.
How we did it
Take a look https://t.co/417qD5B1nb— Rep. Mike Coffman (@RepMikeCoffman) March 6, 2017
What we found
Page 2 - 4: Decreasing funding to clinics that provide abortions
This section, early in the reform bill, makes clear that no federal funds shall be given to clinics that provide abortions for any reason other than protecting the life of the mother or if the pregnancy is a result of rape or incest. This is just the first time that restrictions on abortions are mentioned in the proposal.
Page 4 - 25: Changes to Medicaid
This section starts by ending Medicaid expansion enrollments after Dec. 31, 2019.
The Medicaid expansion provides coverage for more than 407,000 people in Colorado. These individuals did not qualify for Medicaid prior to the enactment of the Affordable Care Act. The ACA increased income eligibility to those making up to 138 percent of the federal poverty line and includes adults without children.
The proposed changes to Medicaid Expansion also include ending the “Essential Health Benefits” requirement for those individuals as of Dec. 31, 2019 – page 8.
The essential health benefits are the following 10 services that must be covered by insurance under the ACA: https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/ehb-2-20-2013.html
1. Ambulatory patient services
2. Emergency services
4. Maternity and newborn care
5. Mental health and substance use disorder services, including behavioral health treatment
6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care
If the Republican Plan were to pass, as it is written today, these benefits would not be required coverage for Medicaid insurance providers starting in 2020.
Page 10: Lottery Winnings
The Republican plan outlines the ways in which lottery winnings will count towards income eligibility, meaning a lottery winner could lose the Medicaid coverage.
Page 23: Medicaid Eligibility
The American Health Care Act outlines ways to incentivize states to increase the frequency of evaluating an individual’s Medicaid eligibility.
In Colorado, adults are reevaluated on a month to month basis, according to the Colorado Department of Health Care Policy and Financing.
The proposed American Health Care Act would encourage states to reevaluate Medicaid eligibility at least every 6 months and provide funds to help states accomplish the task, or charge penalties if states provide benefits to those individuals who do not qualify.
Pages 45 - 61: Funds provided to States; the “Patient and State Stability Fund”
Under the proposed American Health Care Act, states would receive block grants that could pay for a variety of programs aimed to “meet the unique needs of their patient populations.”
Some of the items spelled out starting on page 46 include programs like the program to stabilize premiums, or provide assistance to those without employer health insurance. This program would provide $100 billion to states through 2026 (page 51).
Pages 61 - 65: Continuous Coverage Incentive
This plan repeals the individual mandate for insurance (page 84) but in this section, it provides for a different kind of incentive. Under the Republican health care plan, an individual who is not able to prove that he or she had continuous coverage with no gaps longer than 63 days would be subject to an insurance company penalty fee of 30 percent of the monthly premiums for a year.
Page 65: Changes to insurance rates
In this section, the plan changes the current law by increasing the amounts older people may be charged for premiums. Right now, the oldest person on an insurance plan may not be charged more than three times what the youngest person is charged. Under the proposed bill, that ratio would increase. The oldest adult could be charged up to 5 times what the youngest person covered pays.
Pages 67 – 123: Changes to Tax policy
The end of this document includes the following items: changes to current tax credits, repeal of some taxes, ends the individual and employer mandates, establishes new tax credits and allows for more contributions to Health Savings Accounts.
- Page 67 – The proposed legislation ends what is known as “remuneration from certain insurers.” Under the Affordable Care Act, health insurance companies may not deduct more than $500,000 of the executives’ compensation as business expenses.
- Page 68 - Repeals the tanning bed tax
- Page 69 – Repeals prescription drug tax and the health insurance tax
- Page 70 – Repeals net investment income tax
- Page 71 – Begins the section on modifying premium tax credits. Premium tax credits are considered subsidies. The credits are paid up front to people to help pay for insurance premiums. The program is based on income. The less money you make, the less you’ll pay for premiums. Instead, you’ll get more credits. The more money you make, the greater percentage of your income you’ll pay for your premiums before you receive the tax credits. This section would alter and ultimately repeal the premium tax credit as of Dec. 31, 2019 (page 80).
- Page 81 – Disallows tax credits to small businesses whose insurance covers abortion
- Page 84 – The individual mandate repealed effective Dec. 31, 2015
- Page 84 – Employer mandate also repealed effective Dec. 31, 2015
- Page 85 – Repeals tax on insurance premiums or benefits
- Page 85 – Repeals tax on over the counter meds
- Page 86 – Decreases taxes on Health Savings Accounts and strikes limitations
- Page 87 – Repeals medical device excise tax
- Page 91 – Establishes new tax credit amounts by age
- Page 120 – Contributions to Health Savings Account may equal deductible and out of pocket max as established by the language in the Affordable Care Act.
FULL DOCUMENT: Read the full American Health Care Act
This is the bare minimum explainer on what the new bill would and wouldn’t cover, the content of which will be debated in the coming weeks. 9NEWS will continue to update this as changes are made in the coming weeks and we will attempt to VERIFY the information as it is released. If you have something you’d like us to VERIFY concerning health care, contact us at firstname.lastname@example.org