The House of Representatives March 24 pulled the American Health Care Act (AHCA, H.R. 1628) just ahead of the scheduled floor vote. The bill repeals significant portions of the Affordable Care Act (P.L. 111-148 and P.L. 111-152) and changes the Medicaid financing structure [see Washington Highlights, March 10].
The House was initially scheduled to vote on the bill on March 23, but House Republicans delayed the vote to make changes to the legislation in order to secure additional support from more conservative members. The House Rules Committee passed several manager’s amendments, including changes to:
Offer states the option to convert Medicaid for children and non-disabled adults to a block grant program;
Further restrict Medicaid expansion to only allow states that have already expanded Medicaid to receive enhanced federal funding for expansion adults through Dec. 31, 2019;
Give states the option to condition Medicaid eligibility on compliance with work requirements for certain adults;
Eliminate the ACA’s essential health benefits beginning in 2018 and allow states to set health plan benefit requirements; and
Accelerate many of the proposed legislation’s tax changes.
The Congressional Budget Office (CBO) March 23 released an updated score of the bill that reflected several of the manager’s amendments. According to the updated score, the AHCA is expected to reduce the deficit by $150 billion over 10 years. Prior scores had estimated a decrease of $337 billion over the same time period [see Washington Highlights, March 17]. The updated score was unchanged from original estimates that 24 million fewer individuals would have insurance under AHCA.
The next steps for House Republicans and the AHCA are unclear at this time.