The future of health care in America is a hot button issue that everyone seems to have an opinion about. During the last election cycle, the Affordable Care Act (ACA) took center stage as candidates shared their ideas on just how they would improve the system for Americans.
This year, the Trump Administration’s proposed repeal and replacement of the Affordable Care Act has dominated the news and been a steady source of debate both in Washington D.C., and dinner tables across America. Since March, Congress has been drafting, debating and voting on proposed changes to the law. Options that have been presented range from a complete repeal and replacement of the law, to a “skinny repeal,” to simply adding amendments that offer states and individuals more freedoms within the ACA. Also during this time, insurers have stepped to the plate to ensure every American has access to insurance options.
Here are some key updates that have taken place this year that will surely shape future efforts surrounding the law:
- March 7, 2017 – Republicans introduce The American Health Care Act of 2017 (AHCA) in the House of Representative. This bill is supported by President Trump.
- March 8, 2017 – Both committees approve the AHCA, with overwhelming support from Republicans, and clear opposition from Democrats (who felt the Congressional Budget Office needed to complete an economic analysis prior to committee voting).
- March 12, 2017 – The Congressional Budget Office (CBO) releases their report on the AHCA, projecting that 52 million Americans would be left uninsured if the act were to become law of the land. The report also stated that insurance premiums would be higher through 2020, and then lower compared to current premiums.
- March 16, 2017 – House Committee votes to send the bill to the floor for a vote, recommending several changes
- March 20, 2017– The Manager’s Amendment is introduced by House Republicans. This amendment attempted to address the committee’s recommendations.
- March 24, 2017 – Due to much debate and dissention among the GOP, the House does not hold a vote and the bill is pulled from the floor. President Trump threatens to “let the marketplaces collapse.”
- April 20, 2017 – House Republicans try again with a revision of the AHCA. This version of the bill introduced the idea of state waivers for key protections of the Affordable Care Act.
- April 24, 2017 – The MacArthur Amendment is introduced by Rep. Tom McArthur. This amendment offered states waivers from the federal government to opt out of many customer protections of the Affordable Care Act. Insurers would be able to charge customers more based on age, eliminate many essential health benefit requirements and charge patients with pre-existing conditions higher premiums.
- May 3, 2017 – Senator Fred Upton introduces a bill that would create an $8 billion fund made available to states from 2018 – 2023. This fund would be given to states to offset higher premium costs for consumers with pre-existing conditions.
- May 4, 2017 – The AHCA passes the House of Representatives (217 – 213) with all the new amendments included. Immediately following the vote, Republican Senators announce that they will be drafting their own legislation, instead on voting on the passed bill.
- May 9, 2017 – Majority Leader Mitch McConnell creates GOP a 13-member working group to draft a bill. The group is criticized for failing to include women members of his own party.
- June 22, 2017 – The Senate unveils the Better Care Reconciliation Act (BCRA). After its release, prominent Republican Senators spoke in opposition of the bill.
- June 26, 2017– The Congressional Budget Office released its analysis of the bill. According to the results, this bill would leave an estimated 15 million American uninsured by 2018 (in comparison to the Affordable Care Act). By 2026, that number would rise to 22 million.
- June 27, 2017 – The vote on the BCRA is postponed
- July 11, 217 – Senate Majority Leader Mitch McConnell delays the state of the Senate’s August recess to work on improving the BCRA
- July 13, 2017 – Senate amends the BCRA to add suggestions made by Ted Cruz. The Cruz Amendment would allow insurers to offer minimal coverage plans that do not comply with the Affordable Care Act, as long as they also made at least one gold, silver and bronze plan in the Healthcare Marketplace. It also made changes to Medicaid, allowing states to apply for block grant funding for the Medicaid expansion population, and allow state to exceed block grant caps in the case of a public health emergency. This version was immediately met with opposition within the Republican Party.
- July 17, 2017– The Senate’s voted on BCRA is postponed as more Republican Senators publically announce opposition for the bill.
- July 18, 2017 – President Trump tweets that Republicans should let the Affordable Care Act fail, and replace it when the market collapses. This was immediately followed by a “repeal only” bill proposal. Republican Senators quickly announced that they would oppose such a measure, and thus ending the idea. Leader Mitch McConnell announces he will hold a vote on July 24th, even though many believe that he knows the BCRA will not pass.
- July 20, 2017– Senate submits their agreed upon version the BCRA to the Congressional Budget Office. The CBO concludes that this version will reduce the federal deficit by $321 billion between 2017 and 2026, but would increase the number of uninsured Americans to 15 million by 2018. They also projected that by 2020, an additional 19 million more would be left uninsured compared to the current law.
- July 25, 2017 – Republicans announce their plans for a debate and vote on BCRA. Senator McConnell announced after 20 hours of debate, that he would call for a vote on the “clean repeal,” bill they got passed in 2015. If that failed, he planned to call for a vote on the BCRA which included the Cruz and Portman Amendments. If that did not pass, he announced that leadership would introduce a “skinny repeal” bill. This bill would leave the ACA in place without the individual mandate, employer mandate or medical device tax. The motion to debate was successful, and Senate Republicans release the new version of the BCRA with amendments
- July 26 -27, 2017– Several bills, amendments and versions of solutions are presented, debated and voted on. Nothing receives the needed to support or votes to change the current law.
- July 29, 2017 – President Trumps threatens to stop subsidy payments to insurance companies and states.
- August 2, 2017 – Senator Lamar Alexander announced that in September the Senate health committee would hold bipartisan hearings to discuss stabilizing and improving the single payer market.
- August 24, 2017 – The Ohio Dept of Insurance announced that CareSource would sell plans in Paulding County, thus ensuring that every county in the United States would have at least one option in 2018 under the Affordable Care Act.
So, what does all of this mean? In short, The Affordable Care Act is still the law of the land. Each of the original mandates and provisions are still in effect. As most businesses and individuals prepare for upcoming open enrollment periods, Americans are seeking quality, flexibility and options without breaking the bank, and we can help. Navigating this landscape can be overwhelming, and you do not have to do it alone. Contact us today to help bring order and quality to your group insurance needs.