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HEALTH CARE REFORM

Affordable Care Act: 4 Ways It Could Change in 2017

To provide insight into the healthcare policy proposals that Americans may expect in the coming year, national non-profit Transamerica Center for Health Studies (TCHS) has compiled four of the most prominent proposed reforms or statements from President-elect Donald Trump and lawmakers, along with key implications for consumers and states. 

1. President-elect Donald Trump’s Healthcare Reform Statement

The president-elect’s healthcare reform statement suggests a full repeal of the Affordable Care Act (ACA) with a focus on patient-centered health care. He calls for the repeal of the individual mandate that requires Americans to have health insurance or pay a tax penalty, and supports allowing insurers to sell insurance plans across state lines and the creation of high-risk pools for those with pre-existing medical conditions. The statement also expresses support for Medicaid innovation.

“The ACA is still the law of the land, but once president-elect Trump takes office things could quickly change,” said Hector De La Torre, executive director of Transamerica Center for Health Studies. “As an example, the incoming administration will likely peel back the ACA’s Medicaid expansion, so consumers who rely on this program should pay attention to imminent changes.”

2. Empowering Patients First Act of 2015 – Representative (and proposed new Health and Human Services Secretary) Tom Price

H.R. 2300, Empowering Patients First Act seeks to:

  • Repeal the ACA and the individual mandate and tax penalty for the uninsured
  • Replace current subsidies to purchase a health plan through an Exchange with tax credits of $1,200 for adults and $900 per child
  • Replace guaranteed issue for individuals with pre-existing conditions with a continuous coverage provision that would prohibit insurers from denying coverage to individuals with pre-existing conditions provided that the individual remained continuously insured for the previous 18 months
  • Allow health insurers to sell plans across state lines
  • Create refundable tax credits for health insurance premiums and HSA contributions, while raising the annual HSA contribution limit and placing a limit on an employer’s contribution to health coverage that can be excluded from the employee’s taxable income
  • Partially fund re-insurance for state high-risk pools for those with serious medical conditions
  • Repeal Medicaid expansion up to 138 percent of the federal poverty level (FPL) and return to 100 percent of FPL; change funding from adjusted amounts per recipient to block grants to states

The Act avoided mention of Essential Health Benefits requirement and allowing young adults under 26 years old to stay on their parent’s health plan.

“As the incoming Health and Human Services Secretary under the Trump administration, Rep. Tom Price will be heavily involved in shaping the future of health care for Americans,” said De La Torre. “Under a proposal like this, Americans with income levels above traditional Medicaid rates and below the ACA expansion rate are most at risk for losing their Medicaid coverage in the coming months.”

3. Patients’ Choice Act of 2009 – House Speaker Paul Ryan

H.R.2520, Patients’ Choice Act seeks to:

  • Repeal the ACA and the individual mandate and tax penalty for the uninsured
  • Replace current subsidies to purchase a health plan through an Exchange with tax incentives of $2,900 per individual or $5,700 per family for those who remain insured from plan year to plan year
  • Create new State Health Insurance Exchanges and allow participants to pay premiums with Health Savings Account (HSA) funds without a tax penalty
  • Replace guaranteed issue for individuals with pre-existing conditions with a continuous coverage provision that would prohibit insurers from denying coverage to individuals with pre-existing conditions provided that the individual remained continuously insured for the previous 18 months
  • Allow health insurers to sell plans across state lines
  • Create state-based high-risk pools for those with serious medical conditions
  • Repeal Medicaid expansion up to 138 percent of the federal poverty level (FPL) and return to 100 percent of FPL; change funding from adjusted amounts per recipient to fixed per capita block grants to states

The Act avoided mention of the Essential Health Benefits requirement and allowing young adults under 26 years old to stay on their parent’s health plan.

“A move toward House Speaker Paul Ryan’s proposed Patients’ Choice Act of 2009 would be felt most by the 9.4 million people who currently receive premium subsidies through Healthcare.gov exchanges,” said De La Torre. “If the new administration eliminates these subsidies, millions of Americans could find their health insurance premiums doubling or even tripling in the near future.”

4. Patient Freedom Act of 2015 – Senator Bill Cassidy

S.1531, Patient Freedom Act

Under the Patient Freedom Act, states could do any of the following: (1) continue implementing the ACA; (2) repeal the core of ACA except to prohibit lifetime or annual limits on health insurance benefits and require coverage of dependents up to 26 years old; (3) or the second option plus implementation of a health savings account (HSA) deposit system. This Act would seek to:

  • Repeal the individual mandate to buy coverage
  • Require states to provide default high-deductible health insurance through a health plan with prescription drug coverage, an adequate provider network, HSA eligibility and childhood immunizations without co-pays
  • Replace current subsidies to purchase a health plan through an Exchange with tax credits of $2,500 for adults and $1,500 per child
  • Require states using HSA deposit systems to provide funds into individual HSAs for health-related costs, including premiums
  • Require no essential health benefits and implement state by state minimum coverage standards
  • Replace guaranteed issue for individuals with pre-existing conditions with a continuous coverage provision mandating that insurers cover individuals with pre-existing conditions, provided that the individual remained continuously insured for the previous 18 months. If continuous coverage is stopped, individual must pay a penalty for each month without coverage up to the date of renewed coverage
  • Allow states to keep their current Exchange or replace it with a state plan
  • Create state-based high-risk pools for those with serious medical conditions
  • Offer optional Medicaid expansion for states

“If the new administration were to adopt key provisions of Senator Bill Cassidy’s proposed Patient Freedom Act of 2015, states would be given more flexibility and the onus would be on them to provide health care insurance options to residents and to work with residing businesses,” said De La Torre.


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