Late last week, the U.S. House of Representatives passed the American Health Care Act of 2017 (AHCA, H.R. 1628) by a slim margin; the bill is an attempt by the Republican congressional majority and the Trump administration to repeal much of the Affordable Care Act. AHCAl passed the House by a count of 217 to 213, along party lines.
The U.S. Senate will now take up the health care battle, and it is expected that Senate Republicans will draft and consider their own version of the American Health Care Act, as reported by the New York Times.
In response to the bill’s passage in the U.S. House of Representatives, the Small Business Majority is urging Congress to drop the bill. In a statement, John Arensmeyer, founder and CEO of the Small Business Majority, said, “This is an irresponsible and costly move that will do little more than create instability in the insurance market and greatly reduce the ability of small business owners, their employees, and self-employed Americans to obtain health coverage. What’s more, we know small businesses strongly support the current health care law and oppose the replacement.”
Some of the key changes that AHCA would make to the Affordable Care Act include:
- Ending the small business tax credit beginning in 2020, per Section 204 of AHCA. Currently, the expense credit is available to businesses with 25 or fewer full-time equivalent employees. The business must be enrolled in a plan offered through the Small Business Health Options Program (SHOP Marketplace) and the credit is available for two consecutive years, after which it is phased out. (More information on the credit is available here.)
- Disallowing the small employer tax credit for any plan that includes coverage for abortions (other than any abortion necessary to save the life of the mother or any abortion with respect to a pregnancy that is the result of an act of rape or incest), also per Section 204 (until its aforementioned phase-out in 2020).
- Eliminating the mandate that an individual buy health insurance or pay a penalty. The bill does allow health insurance companies to charge a 30 percent penalty on those who buy insurance after a gap in coverage that is more than 63 days, as reported by USA Today.
- Allowing health insurance companies to dramatically increase the price of health insurance for older adults by allowing insurers to charge older adults up to five times the rates charged to younger adults. ACA had limited this to three times the rate, the article noted.
- Rolling back Medicaid expansion and giving states the authorization to require “able-bodied” Medicaid recipients to work, attend job-training programs, or do community service.
According to the Economic Policy Institute (EPI), if AHCA becomes law, small retail businesses and others would suffer a decline in sales. “By helping pick up the tab for individual insurance and expanding coverage on Medicaid, the ACA has helped millions of Americans afford their care,” EPI explained. “If this support were withdrawn, people would have less money to spend on other basic necessities like food and rent. Fewer dollars spent at grocery stores and other businesses means 1.2 million jobs would be lost.”
The New York Times article noted that a lot has to happen before the bill becomes law. For one, the Senate’s health care bill will have to comply with special budget rules in order to pass with 51 votes and avoid a filibuster. If the Senate passes its own version of the health care bill, a conference committee will be formed between the House and Senate to merge the two versions.