AHCA 2.0 passed in the House. Let’s analyze some of the issues important to us all. With a little commentary mixed in.

Now that the House has passed its version of the AHCA and had its celebration in the Rose Garden AHCA 2.0 (as we’ll call it) heads toward the Senate. Some say that the Senate will take 2-3 months to work through its process while others suggest it will take many months. Either way we have plenty of time to discuss and digest the House HR1628.

First, let me admit that I was not correct last week when I predicted the House would not actually vote on the amended version of the American Healthcare Act. Second, I want to recommend to everyone not to get too over-stressed about the House’s bill because the Senate may, or at least should, make significant modifications.

But, we need to keep the conversation active and look for the positives we change pursue or else the Politicians may think we’re not watching what they are doing and we don’t want them to overlook the fixes that are needed.

Before we start I will make a couple points. One is that there are many details to specific provisions that are yet to be provided which is concerning. Before we can truly analyze certain benefits such as Pre-ex condition and the Mandates actually apply, we need clarification.

The second is that since AHCA 2.0 does not completely repeal the ACA nor eliminate the ACA’s ability to be quickly resurrected the Republicans have their political necks stretched way out over the chopping block.
If AHCA 2.0 falters, in anyway, Democrats can re-activate the ACA when they get a Democrat in the President’s office using the Departments of HHS, CMS, and IRS. That’s two big strikes against the Republicans and we all know how many strikes we get, right?  But for today let’s review what AHCA 2.0 provides based on information available.

Let me outline some the topics we need to discuss but I will address only a few in each of the next couple weeks. Let’s face it we seem to have the time and no need to over-dose. So here we go:

* Mandate for Individual * Mandate for Employer
Abortion coverage * Guarantee Issue
Continuous coverage incentive * Pre-existing conditions
* Refundable tax credits * Tax deductibility
5:1 pricing * Medicare Expansion * Health Ins Tax
* Invisible Risk Sharing program * State waiver of EHP
* HSA limits *
FSA limits * HRAs * and much more.

There are many more issues that we will address over the coming weeks but let’s start with six for these each week. So let’s start with:

Mandate for Individuals –
you will hear proponents say that this mandate is repealed but that is not true. The mandate is still as alive as before but the penalty or fine/tax is reduced to zero.
Mandate for ALE Employers – same as with the individual mandate. This mandate is still alive and could be activated by future administrations with little effort.
Pre-existing conditions – This is the big one and I beg your patience but it’s still unclear to me exactly how it applies. This provision would only apply to people who have a “gap” in their coverage for longer than 63 days. But I am unclear about how the “pre-ex” provision will be applied to members for whom it does apply when they seek coverage. Is the member covered for every thing else but the pre-ex condition? How long does the pre-ex remain in place? Does it apply in employer sponsored plans as well as individual plans?
Sorry, but we must get clarification on this one!
Abortion coverage – plans that include coverage for abortion, except in the case of the life of the mother, can not benefit from the provisions that assist the member in anyway. That means assistance in paying premium, tax deductibility, and so forth would not apply to plans that cover abortion.
Plans that cover abortion can be offered by insurers but members can’t receive the assistance built into the AHCA 2.0.
Guarantee Issue – All plans must be issued on a guaranteed basis regardless of health history or previous coverage.
Incentive for continuous coverage – This is AHCA 2.0’s attempt to encourage people to enroll or face the penalty of their premium being increased by 30%. It is unclear to me how effective this will be but also how it will actually work. It appears to apply to small group plans as well as individual plans. That means employer plans could have some employees covered that are being surcharged 30% while others are not. (Note, it sounds as though the premium subsidies may actually be available to assist late enrollees so the success of this provision questionable)

That’s six specific provisions for today. I look forward to watching as the Senate wrestles with AHCA 2.0. Let’s see if the Senate’s actions are influenced by the Democrat’s and liberal media’s efforts to muddle and distort the facts. We’ll sort it out together.

As usual I am interested to hear what you think because we are all in this together.

Until next time,

Mark Reynolds, RHU

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