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Republicans Release ACA Replace Bill: What are the Changes?

On Monday, March 6, 2017, the Republican controlled House released the American Health Care Act ("AHCA"), the long awaited replacement bill for the Affordable Care Act ("ACA"). We have created a comparison chart on some of the key provisions of the ACA and how they fair in the AHCA.

Affordable Care Act

American Health Care Act-
introduced 3/6/2017

Individual Mandate: required individuals to obtain health insurance or face tax penalties.

Individual Mandate: the AHCA has no coverage requirements for individuals.

Employer Mandate: required companies with 50 or more employees to provide employer sponsored health insurance or face financial penalties.

Employer Mandate: There is no requirement for employers to provide employer sponsored health insurance in the AHCA.

Premium subsidies: The ACA provided tax credits based on a sliding scale according to income.

Premium subsidies: The AHCA uses age instead of income to distribute subsidies. Individuals making less than $75,000 and households under $150,000 would be eligible for the premium subsidies.

Medicaid expansion: Expanded Medicaid by raising the eligibility cutoff to 138% of the poverty level.

Medicaid expansion: Allow states to keep the expansion through 2020. Eligibility would be reduced start in 2020.

Health savings account: Under the current law, in 2017, an individual can put $3,400 and a family $6,750 into a tax-free health savings account.

Health savings account: Almost doubles the amount an individual or family can save in the tax-free account, $6,550 for an individual and $13,100 for a family beginning in 2018.

Age Rating: The ACA capped the amount an insurer could charge based on age, 3 to 1.

Age Rating: Increases the band to 5 to 1 and allows for states to set their own band.

Dependent coverage until 26: The ACA allowed for dependents to remain on their parents' insurance until age 26.

Dependent coverage until 26: The AHCA continues to allow for dependents to remain on their parents' insurance until age 26.

Pre-existing conditions policy: The ACA required insurers to provide insurance to individuals regardless of pre-existing conditions.

Pre-existing conditions policy: The AHCA maintains this policy.

Essential health benefits: The ACA required every health insurance plan to offer 10 essential health benefits.

Essential health benefits: The AHCA maintains this coverage requirement.

Prohibitions on annual and lifetime limits: The ACA barred insurers from capping the dollar amount they would spend on covering an individual.

Prohibitions on annual and lifetime limits: The AHCA keeps the prohibition in place on capping the dollar amount of insuring an individual.

The NASE continues to review and assess the AHCA as its potential impact on the self-employed community. Check back for more analysis in the coming days. 

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