House Republican Healthcare Bill Released on Monday

March 8, 2017

On Monday night, Republican leaders from two House committees—the House Energy and Commerce Committee, chaired by Congressman Greg Walden (R-OR), and the House Ways and Means Committee, chaired by Congressman Kevin Brady (R-TX)—released long-awaited draft bills to repeal and replace the Affordable Care Act (ACA). Both committees are marking up their respective bills today.

For information about the bills, please see:

• The full text of the House Ways and Means Committee’s American Health Care Act
• The full text of the Energy and Commerce Committee’s American Health Care Act
• A section-by-section summary of the House Ways and Means bill
• A section-by-section summary of the House Energy and Commerce bill

The provisions in the American Health Care Act include the following:

• Eliminating the ACA’s income-based subsidies and replacing them with a refundable, age-based tax credit. This would mean millions of Americans who were able to obtain health insurance with the help of ACA subsidies would most likely no longer be able to afford insurance.
• Rolling back the Medicaid expansion and converting payments to states to a per capita cap system, in which states are given a set amount for the number of people in categories including the disabled, elderly, childless adults and pregnant mothers. This would most likely deny coverage to millions of Americans who were able to enroll in Medicaid due to the expansions and would likely impose much higher costs to states.
• Replacing the individual and employer mandates with a “continuous coverage” requirement, allowing insurers to charge more to customers who drop coverage. This provision would potentially undermine one of the ACA’s greatest achievements—granting protection to those with pre-existing conditions—by forcing those with any significant gap in their insurance coverage to pay large penalties.
• Allowing insurance companies to raise premiums and out-of-pocket costs, especially for seniors.
• Repealing the Prevention and Public Health Fund (PPHF) after Fiscal Year 2018. Repealing the PPHF without a corresponding increase in the allocation for the Labor-Health and Human Services-Education appropriations bill would leave a funding gap for essential public health programs. Today, more than 12% of CDC’s budget is supplied through PPHF investments. This includes core public health programs that provide essential funds to help states keep communities healthy and safe, such as immunization programs, epidemiology and laboratory capacity grants, the entire Preventive Health and Health Services (Prevent) Block Grant program, cancer screenings, chronic disease prevention and other critically important programs.
• Expanding health savings accounts.
• Defunding Planned Parenthood, which would cut off health care—including birth control, cancer screenings and other essential health services—for millions of women who have no other healthcare provider.

The Office of Management and Budget (OMB) has not yet scored the legislation, so it is unclear how much the plan would cost.

President Donald Trump touted the plan Tuesday on Twitter: “Our wonderful new Healthcare Bill is now out for review and negotiation. ObamaCare is a complete and total disaster - is imploding fast!”

Other members of the Republican party, however, are not so excited about the proposal. House conservatives have declared strong opposition, saying the refundable tax credits would create a new, expensive entitlement program. A staff report prepared for the Republican Study Committee criticizes a key component of the plan, calling the refundable tax credits “a Republican welfare entitlement.” In addition, Republican lawmakers have to contend with rising support for the ACA among constituents.

On the other side of the aisle, Democrats are not wavering in their opposition to ACA repeal. Democrats argue that people currently covered under Obamacare would be worse off under this plan. “The Republican repeal bill would charge them more money for less care,” Representatives Frank Pallone (D-NJ), ranking member of the House Energy and Commerce Committee, and Richard Neal (D-MA), ranking member of the House Ways and Means Committee, said in a statement.

Many public health, nutrition, and anti-poverty groups have spoken out against the legislation and drafted resources delineating the damages this legislation would inflict on the most vulnerable Americans:

• The Kaiser Family Foundation’s interactive map estimating tax credits, a key component based on income and age.
• Analysis from the Center on Budget and Policy Priorities: House GOP Medicaid Provisions Would Shift $370 Billion in Costs to States Over Decade.

This bill would make health care coverage less affordable, less accessible, and less comprehensive and leave millions of people with chronic illness and disease at the mercy of insurance companies. According to a preliminary analysis from the rating agency Standard & Poor's, 6-10 million people could lose health insurance coverage if the Republican plan passes. Furthermore, the reductions in Medicaid funding called for in these bills would have real life consequences for WIC families and could potentially affect WIC participation and Medicaid Adjunctive Eligibility.

It should be noted that many of the bills’ provisions aren’t eligible for the reconciliation process, which requires provisions to have budgetary effects and allows policies to be passed with only a simple majority in the Senate (51 votes). In other words, parts of the bill will require 60 votes in the Senate. Given this fact, along with the vocal opposition to the bill from both political parties, it appears unlikely that this legislation will advance very far.

The National WIC Association will continue to work with our national partners and our friends in Congress to ensure that the consequences of the American Health Care Act do not have adverse impacts on current and potential ACA beneficiaries. If you would like to get involved in this effort, please consider the following actions:

• Share a story of how the ACA has made a difference in your life or the lives of your loved ones. Right now, it’s more important than ever to come forward and share your experiences. By telling us your story, you help speak for people who may be facing issues just like yours.
• Take action by e-mailing or calling your representative and letting them know that you oppose the adverse impacts of the American Health Care Act. If you already know your representative, you can simply call the capital switchboard at (202) 224-3121; if you don't know your representative, visit the house.gov website and find your representative by typing in your zip code. If you can’t reach the Washington office you may call the district office number on the member's page.