The changes to the ACA addressed in the American Health Care Act will not be final until passed by Congress but already criticism of some of the key aspects are being voiced by some Republican Senators. All are from states that expanded Medicaid under the ACA and indicated they would not support a plan that would leave millions of Americans uninsured. In a letter to Senate Majority Leader Mitch McConnell, Senators Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Cory Gardner of Colorado and Lisa Murkowski of Alaska stated “We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states.”
Medicaid expansion implemented in the ACA would end in 2020 under the new Act. People already enrolled would continue to get coverage, but new enrollees would be prohibited, and those who leave coverage could not return to expanded coverage.
Other key changes include:
- Suspension of the mandate requiring individuals to sign up for health insurance – However, there would be a 30% surcharge if you let your coverage lapse and want to get coverage at a later date.
- Elimination of the premium subsidies for those with low to middle incomes – These would be replaced with tax credits for individuals who have annual incomes below $75,000 or married couples with annual incomes below $150,000.
- Pre-existing conditions will continue to be covered and charged at the same rate as those without pre-existing conditions. The ban on lifetime and annual limits would remain in place.
- Some large employers would not have to offer health coverage to employees – However, the 40% Cadillac Tax would remain in effect on plans that cost more that $10,200 for individuals and $27,500 for families.
- Under the new plan insurers could charge older people five times what they charge younger ones. Under the ACA, it was capped at three times the rate.
- Children up to age 26 can remain on their parents’ plans under the American Health Care Act – Same as the ACA