The U.S. House of Representatives took steps to repeal and replace the Affordable Care Act by passing H.R. 1628, the American Health Care Act (AHCA) on May 4. H.R. 1628 repeals several of the most harmful and burdensome provisions of the ACA, including the employer mandate penalty, costly tax increases and limitations on contributions to and restrictions on the use of flexible spending accounts and health savings accounts. ABC sent a letter in support of H.R. 1628 to the U.S. House of Representatives, which passed the House by a vote of 217-213. The bill now awaits action in the U.S. Senate.

A summary of H.R. 1628 and the amendments is available, here.  

Background on the American Health Care Act:
 
House Republicans unveiled the AHCA on March 6, and it advanced in the energy and commerce, ways and means, budget and rules committees.
 
On March 13, the Congressional Budget Office (CBO) estimated that the AHCA will reduce the federal deficit by $337 billion over 10 years as well as increase the number of uninsured to 24 million in 2026 compared to current law. In addition to reducing the federal deficit, Speaker Ryan stated that the CBO report validated that the AHCA will lower premiums by 10 percent and cut taxes by $880 billion
 
Following the CBO’s March 13 analysis, technical and policy changes were made to the AHCA, and on March 23, CBO revised its cost estimates to reflect the manager’s amendments. Amendments to the bill can be found here

During the week of March 20, Republican leadership in the House scheduled a vote on H.R. 1628. ABC joined the U.S. Chamber of Commerce and several other organizations in sending a letter to the House in support of the AHCA on March 22. But on March 24, the bill was pulled due to a lack of votes.

ABC has advocated for several provisions included in the AHCA:

• Zeroes out the penalties for the employer mandate (retroactive to Jan. 1, 2016). 
• Repeals the flexible spending account (FSA) contribution limit.
Increases the maximum contribution limit on health savings accounts (HSA).  
• Repeals the restriction on over-the-counter medications for FSAs and HSAs.  
• Repeals the net investment income tax
• Repeals the Health Insurance Tax, or the HIT (ABC is a member of the Stop the HIT Coalition)
• Repeals the medical device tax 

On April 26, the co-chair of the moderate Tuesday Group, Rep. Tom MacArthur (R-NJ), and the chairman of the Freedom Caucus, Mark Meadows (R-N.C.) proposed revisions to H.R. 1628, known as the MacArthur Amendment. The amendment provided states the option to apply to waive essential health benefits, age rating, and community rating. 

On May 3, Rep. Fred Upton (R-Mich.) introduced an amendment, which made an additional $8 billion from 2018 to 2023 available for states through an application process specified by the MacArthur amendment. 

ABC will continue to provide updates in Newsline on the status of the AHCA and other health care issues that impact ABC members.