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Once again Health Care reform is in the news.  The house just passed a bill to repeal and replace the Affordable Care Act (Obamacare).  This changes the one proposed in March by allowing states to opt out of providing coverage for pre-existing conditions and more.  This bill will now go to the Senate and may change again.  We've created a chart comparing the Affordable Care Act vs. American Health Care Act to help you decipher what these changes may mean to you.  Hopefully this will help!  Please call us if you have any questions. 

    

Topic

Affordable Care Act (ACA or Obamacare)

American Health Care Act (ACHA)

House Approved Bill

     Premium Tax Credits (Subsidy)

ACA is based on income, age, and local cost of insurance. An individual making under $46,000 annually could qualify.

AHCA is based on age, ranging from $2,000 a year for people in their 20s to $4,000 for those older than 60. Click here to see how this may impact you.

     Buying Insurance

· Requires individuals to purchase insurance or pay a penalty.

· Requires Employers with over 50 full time employees to provide affordable health insurance, or pay a penalty.

· Requires individuals to purchase insurance through the Health Insurance Marketplace if they want to use a subsidy.

· People can purchase insurance only during the open enrollment period, or if they qualify for a “special enrollment”. This applies to plans purchased through both the Marketplace and directly through private insurers.

· Does not require people to buy insurance through the Health Insurance Marketplace if they want to use a subsidy.

· Encourages people to have health insurance, and as long as you don’t lapse your coverage, insurers can’t cancel your coverage or charge more for pre-existing conditions.

· If you lapse your coverage more than 63 days, insurers can charge a 30% penalty over the premium for one year.

     Taxes

The ACA includes taxes for incomes over $200,000 ($250,000 for a married couple), a tax on health insurers, a limit on how much insurance companies can deduct for executive pay, and a tax on medical –device manufactures.

Eliminates all taxes that were included under the ACA.

     Medicaid

Expanded eligibility to include individuals who fall between 100-135% of the poverty line.

Would roll back the expansion starting in 2019 by cutting the federal reimbursement to states for anyone who leaves Medicaid. The result would be an ever dwindling of people covered under Medicaid.

     Pre-Existing Conditions

Insurers must cover pre-existing conditions.

Protects people with pre-existing conditions with exceptions:

· States can apply for a waiver that would let them opt out for most of the regulations and consumer protections.

· States can apply for a waiver that would allow the insurance companies to:

1. Charge older people more than 5 times what they charge young people.

2. Eliminate essential health benefits including maternity, mental health, and prescription drugs.
3. Charge more for or deny coverage to people who have pre-existing conditions such as cancer, diabetes or arthritis. Those states would be required to create high risk pools.

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