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Rep. Graves, House Pass Historic Obamacare Repeal and Replace Bill

Washington, May 4, 2017 - Rep. Tom Graves (R-GA-14) voted for and the House passed the American Health Care Act (H.R. 1628), Phase 1 of President Trump’s healthcare plan. Speaking of the historic vote, Rep. Graves said:

“The first bill I introduced after I was elected to Congress in 2010 was legislation to defund Obamacare. Over the last seven years we kept fighting, we never gave up, and now we’re finally passing a bill to repeal and replace Obamacare that will hit the desk of a president who will sign it. This is Phase 1 of the President Trump’s three phase healthcare plan. Taken together, the president’s plan will reduce health insurance premiums, increase access to care and put patients first.”

H.R. 1628 includes the MacArthur-Meadows Amendment that gives states additional flexibility by allowing them to apply with the U.S. Department of Health and Human Services to waive certain federal mandates if the state can prove its plan will benefit consumers.  

Speaking of the change, Rep. Graves said: “Importantly, the American Health Care Act continues to protect people with pre-existing conditions from price gouging, and they cannot be denied coverage. What’s new is that each state can take its own approach, as long as there are basic protections and clear benefits, such as increasing enrollment, offering more choices and lowering costs. A lot of work has gone into finding the right balance between lifting federal mandates and protecting Americans with serious health challenges, and I believe this is it.”

President Trump’s healthcare plan has three concurrent phases:

(1)   The American Health Care Act, which repeals Obamacare's taxes and mandates, and replaces them with expanded Health Saving Accounts and age-based tax credits to help low- and middle-income families in the individual market purchase health insurance; additionally, the bill makes significant reforms to Medicaid, such as allowing states to receive federal funds through block grants and pursue work requirements for able-bodied adults without dependents;

(2)   Administrative Actions, which Health and Human Services Secretary Tom Price will take to eliminate harmful regulations and allow more choice and competition in the health insurance marketplace;

(3)   Additional Legislation, to increase competition and expand access to care, including legislation passed by the House in March – the Competitive Health Insurance Reform Act (H.R. 372) and the Small Business Health Fairness Act (H.R. 1101).

Below is a summary of the American Health Care Act (prepared by the Republican Policy Committee).

Repealing Obamacare

  • Repeals both the individual and employer mandate penalty.
  • Repeals the Obamacare subsidies in 2020.
  • Repeals tax increases associated with Obamacare.
  • Repeals the Obamacare Prevention and Public Health fund and rescinds all unobligated balances.

Providing Tax Credits

  • Provides an advanceable, refundable tax credit for individuals and families who do not get health insurance through their employer or the government.
    • The credit is adjusted for age and grows over time, with a maximum credit of $4,000 for an individual and $14,000 for a family.
    • The credit is available in full to those making up to $75,000 per year ($150,000 for joint filers) and phases out by $100 for every $1,000 in additional income above those thresholds.

Expanding Health Savings Accounts (HSAs)

  • Increases contribution limits for Health Savings Accounts. In 2017, those levels would be equal to $6,550 for individuals (up from $3,400) and $13,100 for families (up from $6,750).
  • Allows spouses who are HSA-eligible and age 55 or older to deposit their catch-up contributions into one HSA account.
  • Treats HSAs as having been opened on the same day as the high-deductible health plan so there are no gaps in which HSA funds can be used for qualified medical expenses.

Freezes Medicaid Expansion and Incorporates Reform

  • Freezes Medicaid expansion, at which point states can only enroll newly eligible. individuals at the State’s traditional FMAP for that individual.
  • Repeals the Medicaid Disproportionate Share Hospital cuts to non-expansion states in 2018 and for expansion states in 2020.
  • Requires individuals to provide documentation of U.S. citizenship or lawful presence before obtaining Medicaid coverage.
  • Creates a per capita model for states starting in FY2020.
  • Modernizes Medicaid’s data and reporting systems.

Establishes a Stability Fund

  • Establishes the Patient and State Stability Fund to lower patient costs and stabilize insurance markets by providing $15 billion for states in FY2018 and FY 2019 and $10 billion for FY2020-2026.

Additional Provisions

  • Establishes a continuous health insurance coverage incentive by assessing a flat 30% late enrollment surcharge when purchasing health insurance after at least a 63-day lapse in health insurance.
  • Repeals the actuarial value standards established by Obamacare (bronze, silver, gold, platinum) to improve flexibility in plan design.
  • Adjusts the ratio for age variation in health insurance premium rate to five-to-one, while also giving states the flexibility to set their own ratio.

Additional Amendments

  • Prohibiting excess tax credits from being deposited into an HSA.
  • Creating fiscal space to reduce the health costs for individuals in the 50-64 age group.
  • Immediately prohibiting any new state expanding Medicaid at Obamacare’s enhanced matching rate.
  • Offering voluntary work requirements for Medicaid with state incentives.
  • Allowing states to receive an optional Medicaid block grant for adults and children.
  • Institutes a new higher growth rate for the Aged and Disabled population within the per capita Medicaid funding formula.
  • Reducing the allowable expenditures for certain states that force counties to fund Medicaid.
  • Advancing repeal dates for Obamacare tax increases from 1/1/18 to 1/1/17.
  • Extending an additional year of relief from Cadillac tax repeal.
  • Requires states to determine essential health benefits for plans that are eligible for the premium tax credit.
  • Delays the repeal of the additional .9 percent Medicare tax on high-income earners until December 31, 2022.
  • Provides an additional $15 billion for the Patient and State Stability Fund for mental health and substance use disorders and maternity care.
  • Provides clarification that mental health and substance use disorder services within the fund includes inpatient and outpatient clinical care for treatment of addiction and mental illness, and early identification and intervention for children and young adults with serious mental illness.


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