{ "id": "R44785", "type": "CRS Report", "typeId": "REPORTS", "number": "R44785", "active": true, "source": "EveryCRSReport.com", "versions": [ { "source": "EveryCRSReport.com", "id": 461560, "date": "2017-05-26", "retrieved": "2017-06-07T15:33:52.878967", "title": "H.R. 1628: The American Health Care Act (AHCA)", "summary": "In January 2017, the House and Senate adopted a budget resolution for FY2017 (S.Con.Res. 3), which reflects an agreement between the chambers on the budget for FY2017 and sets forth budgetary levels for FY2018-FY2026. S.Con.Res. 3 also includes reconciliation instructions directing specific committees to develop and report legislation that would change laws within their respective jurisdictions to reduce the deficit. These instructions trigger the budget reconciliation process, which may allow certain legislation to be considered under expedited procedures. The reconciliation instructions included in S.Con.Res. 3 direct two committees in each chamber to report legislation within their jurisdictions that would reduce the deficit by $1 billion over the period FY2017-FY2026. In the House, the Committee on Ways and Means and the Energy and Commerce Committee are directed to report. In the Senate, the Committee on Finance and the Committee on Health, Education, Labor, and Pensions are directed to report. \nIn response to the reconciliation instructions, there was activity in four different House committees\u2014Ways and Means, Energy and Commerce, Budget, and Rules\u2014during the first quarter of 2017. The result of this activity was H.R. 1628, the American Health Care Act (AHCA) of 2017. The version of the AHCA as passed by the House on May 4, 2017 (which incorporated eight amendments referenced in H.Res. 228 and H.Res. 308), is the topic of this report. The bill includes a number of provisions that would repeal or modify parts of the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). For example, the bill would repeal the ACA\u2019s cost-sharing subsidies for lower-income individuals who purchase health insurance through the exchanges, and it would substitute the ACA\u2019s premium tax credit for a tax credit with different eligibility rules and calculation requirements. The bill also would repeal some of the ACA\u2019s Medicaid provisions, such as the changes the ACA made to presumptive eligibility and the state option to provide Medicaid coverage to non-elderly individuals with income above 133% of the federal poverty level (FPL). \nThe AHCA also includes a number of provisions that do not specifically relate to aspects of the ACA. For example, the bill would establish a late-enrollment penalty for certain individuals who do not maintain health insurance coverage, and it would create a new fund to provide funding to states for specified activities intended to improve access to health insurance and health care in the state. The bill would convert Medicaid financing to a per capita cap model (i.e., per enrollee limits on federal payments to states) starting in FY2020, and states would have the option to receive block grant funding (i.e., a predetermined fixed amount of federal funding) instead of per capita cap funding for non-elderly, nondisabled, non-expansion adults and children starting in FY2020. \nThis report contains three tables that, together, provide an overview of all the AHCA provisions. Table 1 includes provisions that apply to the private health insurance market, Table 2 includes provisions that affect the Medicaid program, and Table 3 includes provisions related to public health and taxes. Each table contains a column identifying whether the AHCA provision is related to an ACA provision (e.g., whether the AHCA provision repeals an ACA-related provision). In addition to the three tables, the report includes more detailed summaries of each AHCA provision and two graphics showing the effective dates of AHCA provisions. Figure 1 covers AHCA provisions related to the private health insurance market, public health, and taxes. Figure 2 covers AHCA provisions related to the Medicaid program. \nThe Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) issued a cost estimate for the AHCA, as passed by the House on May 4, 2017. According to the estimate, the AHCA would reduce federal deficits by $119 billion over the period FY2017-FY2026. With respect to effects on health insurance coverage, CBO and JCT project that, in CY2018, 14 million more people would be uninsured under the AHCA than under current law, and in CY2026, 23 million more people would be uninsured than under current law.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R44785", "sha1": "76532b169f7c8c330febcdb428511938dfd94c96", "filename": "files/20170526_R44785_76532b169f7c8c330febcdb428511938dfd94c96.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R44785", "sha1": "ef146e91ddb40cb413743e97877a410a6fc55a21", "filename": "files/20170526_R44785_ef146e91ddb40cb413743e97877a410a6fc55a21.pdf", "images": null } ], "topics": [ { "source": "IBCList", "id": 4790, "name": "Private Health Insurance" }, { "source": "IBCList", "id": 4819, "name": "Medicaid & CHIP" }, { "source": "IBCList", "id": 4881, "name": "Health Care Reform" } ] }, { "source": "EveryCRSReport.com", "id": 460956, "date": "2017-05-08", "retrieved": "2017-05-09T14:57:52.602759", "title": "H.R. 1628: The American Health Care Act (AHCA)", "summary": "In January 2017, the House and Senate adopted a budget resolution for FY2017 (S.Con.Res. 3), which reflects an agreement between the chambers on the budget for FY2017 and sets forth budgetary levels for FY2018-FY2026. S.Con.Res. 3 also includes reconciliation instructions directing specific committees to develop and report legislation that would change laws within their respective jurisdictions to reduce the deficit. These instructions trigger the budget reconciliation process, which may allow certain legislation to be considered under expedited procedures. The reconciliation instructions included in S.Con.Res. 3 direct two committees in each chamber to report legislation within their jurisdictions that would reduce the deficit by $1 billion over the period of FY2017 through FY2026. In the House, the Committee on Ways and Means and the Energy and Commerce Committee are directed to report. In the Senate, the Committee on Finance and the Committee on Health, Education, Labor, and Pensions are directed to report. \nIn response to the reconciliation instructions, there was activity in four different House committees\u2014Ways and Means, Energy and Commerce, Budget, and Rules\u2014during the first quarter of 2017. The result of the activity was H.R. 1628, the American Health Care Act (AHCA) of 2017. The version of the AHCA as passed by the House (which incorporated each of the eight amendments referenced in H.Res. 228 and H.Res. 308) is the topic of this report. The bill includes a number of provisions that would repeal or modify parts of the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). For example, the bill would repeal the ACA\u2019s cost-sharing subsidies for lower-income individuals who purchase health insurance through the exchanges, and it would substitute the ACA\u2019s premium tax credit for a tax credit with different eligibility rules and calculation requirements. The bill also would repeal some of the ACA\u2019s Medicaid provisions, such as the changes the ACA made to presumptive eligibility and the state option to provide Medicaid coverage to non-elderly individuals with income above 133% of the federal poverty level (FPL). \nThe AHCA also includes a number of provisions that do not specifically relate to aspects of the ACA. For example, the bill would establish a late-enrollment penalty for certain individuals who do not maintain health insurance coverage, and it would create a new fund to provide funding for states for specified activities intended to improve access to health insurance and health care in the state. The bill would convert Medicaid financing to a per capita cap model (i.e., per enrollee limits on federal payments to states) starting in FY2020, and states would have the option to receive block grant funding (i.e., a predetermined fixed amount of federal funding) instead of per capita cap funding for non-elderly, nondisabled, non-expansion adults and children starting in FY2020. \nThis report contains three tables that, together, provide an overview of all the AHCA provisions. Table 1 includes provisions that apply to the private health insurance market, Table 2 includes provisions that affect the Medicaid program, and Table 3 includes provisions related to public health and taxes. Each table contains a column identifying whether the AHCA provision is related to an ACA provision (e.g., whether it repeals an ACA-related provision). In addition to the three tables, the report includes more detailed summaries of each AHCA provision, and two graphics showing the effective dates of AHCA provisions. Figure 1 covers AHCA provisions related to the private health insurance market, public health, and taxes. Figure 2 covers AHCA provisions related to the Medicaid program. \nThe Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) issued a cost estimate for the AHCA, but their most recent estimate does not incorporate all of the reported amendments to the bill (as described in more detail in the body of this report). According to the estimate, the AHCA would reduce federal deficits by $150 billion over the period FY2017-FY2026. With respect to effects on health insurance coverage, CBO and JCT project that, in FY2018, 14 million more people would be uninsured under the AHCA than under current law and, in FY2026, 24 million more people would be uninsured than under current law.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R44785", "sha1": "a7960516568152a46a709ccb1bf4c709457aa6be", "filename": "files/20170508_R44785_a7960516568152a46a709ccb1bf4c709457aa6be.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R44785", "sha1": "87a9b164548b31c34ce4ebb0043d6f9ee2bc4be6", "filename": "files/20170508_R44785_87a9b164548b31c34ce4ebb0043d6f9ee2bc4be6.pdf", "images": null } ], "topics": [ { "source": "IBCList", "id": 4790, "name": "Private Health Insurance" }, { "source": "IBCList", "id": 4819, "name": "Medicaid & CHIP" }, { "source": "IBCList", "id": 4881, "name": "Health Care Reform" } ] }, { "source": "EveryCRSReport.com", "id": 460364, "date": "2017-04-10", "retrieved": "2017-04-11T14:59:46.790691", "title": "H.R. 1628: The American Health Care Act (AHCA)", "summary": "In January 2017, the House and Senate adopted a budget resolution for FY2017 (S.Con.Res. 3), which reflects an agreement between the chambers on the budget for FY2017 and sets forth budgetary levels for FY2018-FY2026. S.Con.Res. 3 also includes reconciliation instructions directing specific committees to develop and report legislation that would change laws within their respective jurisdictions to reduce the deficit. These instructions trigger the budget reconciliation process, which may allow certain legislation to be considered under expedited procedures. The reconciliation instructions included in S.Con.Res. 3 direct two committees in each chamber to report legislation within their jurisdictions that would reduce the deficit by $1 billion over the period of FY2017 through FY2026. In the House, the Committee on Ways and Means and the Energy and Commerce Committee are directed to report. In the Senate, the Committee on Finance and the Committee on Health, Education, Labor, and Pensions are directed to report. \nOn March 6, 2017, the Committee on Ways and Means and the Energy and Commerce Committee independently held markups. Each committee voted to transmit its budget reconciliation legislative recommendations to the House Committee on the Budget. On March 16, 2017, the House Committee on the Budget held a markup and voted to report a reconciliation bill, H.R. 1628, American Health Care Act (AHCA) of 2017. On March 22, the House Rules Committee held a hearing on the AHCA, and on March 24, the Rules Committee reported H.Res. 228, providing for the consideration of the AHCA. H.Res. 228, which was agreed to by the House on March 24, provided for four hours of debate on the AHCA and automatically amended the AHCA to incorporate five \u201cmanager\u2019s amendments\u201d described as making technical and policy changes to the version of AHCA as reported by the House Budget Committee. After debate occurred on the bill, the Speaker pro tempore postponed further consideration of the bill. On April 6, the House Rules Committee reported H.Res. 254, which provides that should the House return to consideration of the AHCA, an additional amendment would be automatically agreed to, upon adoption of the resolution. This report includes information on the AHCA incorporating each of the six amendments included in H.Res. 228 and H.Res. 254, as noted above.\nThe AHCA includes a number of provisions that would repeal or modify parts of the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) and a number of provisions that do not specifically relate to aspects of the ACA. This report contains three tables that, together, provide an overview of the AHCA provisions. Table 1 includes provisions that apply to the private health insurance market, Table 2 includes provisions that affect the Medicaid program, and Table 3 includes provisions related to public health and taxes. Each table contains a column identifying whether the AHCA provision is related to an ACA provision (e.g., whether it repeals an ACA-related provision). \nThe Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) issued a cost estimate for the AHCA, as amended by four of the five manager\u2019s amendments agreed to under H.Res. 228 (4, 5, 24, and 25 but not 31). The estimate does not incorporate the amendment referenced in H.Res. 254. According to the estimate, the AHCA would reduce federal deficits by $150 billion over the period FY2017-FY2026. With respect to effects on health insurance coverage, CBO and JCT project that, in FY2018, 14 million more people would be uninsured under the AHCA than under current law and, in FY2026, 24 million more people would be uninsured.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R44785", "sha1": "07c2d887c680620ad6efa1b2164ad9e2650ed4b2", "filename": "files/20170410_R44785_07c2d887c680620ad6efa1b2164ad9e2650ed4b2.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R44785", "sha1": "b69f6ec38d54f7e6bc43729eab0cceaa9bd41513", "filename": "files/20170410_R44785_b69f6ec38d54f7e6bc43729eab0cceaa9bd41513.pdf", "images": null } ], "topics": [] }, { "source": "EveryCRSReport.com", "id": 459925, "date": "2017-03-22", "retrieved": "2017-03-29T20:03:56.531138", "title": "H.R. 1628: The American Health Care Act (AHCA)", "summary": "In January 2017, the House and Senate adopted a budget resolution for FY2017 (S.Con.Res. 3), which reflects an agreement between the chambers on the budget for FY2017 and sets forth budgetary levels for FY2018-FY2026. S.Con.Res. 3 also includes reconciliation instructions directing specific committees to develop and report legislation that would change laws within their respective jurisdictions to reduce the deficit. These instructions trigger the budget reconciliation process, which may allow certain legislation to be considered under expedited procedures. The reconciliation instructions included in S.Con.Res. 3 direct two committees in each chamber to report legislation within their jurisdictions that would reduce the deficit by $1 billion over the period of FY2017 through FY2026. In the House, the Committee on Ways and Means and the Energy and Commerce Committee are directed to report. In the Senate, the Committee on Finance and the Committee on Health, Education, Labor, and Pensions are directed to report. \nOn March 6, 2017, the Committee on Ways and Means and the Energy and Commerce Committee independently held markups. Each committee voted to transmit its budget reconciliation legislative recommendations to the House Committee on the Budget. On March 16, 2017, the House Committee on the Budget held a markup and voted to report a reconciliation bill, H.R. 1628, American Health Care Act (AHCA) of 2017. The House Rules Committee scheduled a hearing on the AHCA to occur on March 22, 2017. Preceding the hearing, the Rules Committee made available on its website under the heading \u201cBill Text\u201d several \u201cmanager\u2019s amendments,\u201d described as making technical and policy changes to the AHCA as reported by the House Budget Committee. This report includes information on the AHCA as amended by those \u201cmanager\u2019s amendments.\u201d\nThe AHCA includes a number of provisions that would repeal or modify parts of the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) and a number of provisions that do not specifically relate to aspects of the ACA. This report contains three tables that, together, provide an overview of the AHCA provisions. Table 1 includes provisions that apply to the private health insurance market, Table 2 includes provisions that affect the Medicaid program, and Table 3 includes provisions related to public health and taxes. Each table contains a column identifying whether the AHCA provision is related to an ACA provision (e.g., whether it repeals an ACA-related provision). \nThe Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) estimate that the AHCA (based on the budget reconciliation recommendations of the Committee on Ways and Means and the Energy and Commerce Committee) would reduce federal deficits by $337 billion over the period FY2017-FY2026. With respect to effects on health insurance coverage, CBO and JCT project that, in FY2018, 14 million more people would be uninsured under the AHCA than under current law and, in FY2026, 24 million more people would be uninsured. The CBO is expected to provide an updated estimate that reflects the changes in the legislation being considered by the Rules Committee.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R44785", "sha1": "25947ef49ff3d2390efff0e2e363263495c3c619", "filename": "files/20170322_R44785_25947ef49ff3d2390efff0e2e363263495c3c619.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R44785", "sha1": "2b5c50d2063b8535603f731e4afdc160af91ba0b", "filename": "files/20170322_R44785_2b5c50d2063b8535603f731e4afdc160af91ba0b.pdf", "images": null } ], "topics": [ { "source": "IBCList", "id": 4790, "name": "Private Health Insurance" }, { "source": "IBCList", "id": 4819, "name": "Medicaid & CHIP" }, { "source": "IBCList", "id": 4881, "name": "Health Care Reform" } ] }, { "source": "EveryCRSReport.com", "id": 459786, "date": "2017-03-14", "retrieved": "2017-03-22T18:28:25.313931", "title": "The American Health Care Act (AHCA)", "summary": "In January 2017, the House and Senate adopted a budget resolution for FY2017 (S.Con.Res. 3), which reflects an agreement between the chambers on the budget for FY2017 and sets forth budgetary levels for FY2018-FY2026. S.Con.Res. 3 also includes reconciliation instructions directing specific committees to develop and report legislation that would change laws within their respective jurisdictions to reduce the deficit. These instructions trigger the budget reconciliation process, which may allow certain legislation to be considered under expedited procedures. The reconciliation instructions included in S.Con.Res. 3 direct two committees in each chamber to report legislation within their jurisdictions that would reduce the deficit by $1 billion over the period of FY2017 through FY2026. In the House, the Committee on Ways and Means and the Energy and Commerce Committee are directed to report. In the Senate, the Committee on Finance and the Committee on Health, Education, Labor, and Pensions are directed to report. \nOn March 6, 2017, the Committee on Ways and Means and the Energy and Commerce Committee independently held markups. Each committee voted to transmit its budget reconciliation legislative recommendations to the House Committee on the Budget. Combined, these two bills are referred to as the American Health Care Act (AHCA). The House Committee on the Budget is scheduled to mark up the AHCA on March 16, 2017. \nThe AHCA includes a number of provisions that would repeal or modify parts of the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) and a number of provisions that do not specifically relate to aspects of the ACA. This report contains three tables that, together, provide an overview of the AHCA provisions. Table 1 includes provisions that apply to the private health insurance market, Table 2 includes provisions that affect the Medicaid program, and Table 3 includes provisions related to public health and taxes. Each table contains a column identifying whether the AHCA provision is related to an ACA provision (e.g., whether it repeals an ACA-related provision). \nThe Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) estimate that the AHCA would reduce federal deficits by $337 billion over the period FY2017-FY2026. With respect to effects on health insurance coverage, CBO and JCT project that, in FY2018, 14 million more people would be uninsured under the AHCA than under current law and, in FY2026, 24 million more people would be uninsured.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R44785", "sha1": "79985ab3f58090a6dba33f03bef96c2d347afe6a", "filename": "files/20170314_R44785_79985ab3f58090a6dba33f03bef96c2d347afe6a.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R44785", "sha1": "968f4c680c275516843615041ae57dc6aa780e41", "filename": "files/20170314_R44785_968f4c680c275516843615041ae57dc6aa780e41.pdf", "images": null } ], "topics": [ { "source": "IBCList", "id": 4790, "name": "Private Health Insurance" }, { "source": "IBCList", "id": 4819, "name": "Medicaid & CHIP" }, { "source": "IBCList", "id": 4881, "name": "Health Care Reform" } ] } ], "topics": [ "Aging Policy", "Domestic Social Policy", "Health Policy", "Legislative Process" ] }