The Essential Basics of the House Plan to Repeal and Replace ObamaCare (AKA TrumpCare)

We explain everything you need to know about the latest House ObamaCare repeal and replace plan (TrumpCare).

The House voted Thursday, May 4th, 2017 on their ObamaCare repeal the American Health Care Act amended by the MacArthur Amendment.

The bill passed 217-to-213. The bill will now go to the Senate for review and another vote.

TIP: See a simple summary of the American Health Care Act for the basics or keep reading to learn more.

Below we cover the essentials of what you need to know.

See live coverage: House GOP races toward ObamaCare repeal vote. We will post the results when they are known.

UPDATE: The Bill passed the House 217-to-213, it will now go to the Senate for review and another vote.

How This all Relates to TrumpCare and What the Republican ObamaCare Plan Means for America

TrumpCare describes this bill if it passes and all other healthcare reform under Trump. This includes:

The original American HealthCare Act (what they are trying to pass in the vote noted above):

  • Repeals the mandates for both individuals to pay a fee for not having coverage and for large employers to insure their employees.
  • Freezes Medicaid funding to states beginning in 2018 (this freezes federal funding so states can’t continue to expand Medicaid without raising state taxes).
  • Eliminates most of ObamaCare’s taxes on those with higher incomes, employers, and industry (i.e. the bill is most tax breaks for the top fraction of a percent).
  • Replaces tax credits and out-of-pocket assistance based on income with tax credits based on age and no out-of-pocket assistance. Income-based assistance like Medicaid remains. Notably, tax credits are offered to those making 400% – 600% of the poverty level. This is unlike ObamaCare and may have a positive impact on people.
  • Charges a 30% Fee for 12 months for entering or reentering the market for those who don’t obtain coverage during open enrollment and then maintain coverage.
  • However, it doesn’t do the litigation reform, allow sales across state lines, or make the transparency reform promised on Trump’s site. To be fair this is, even if only unofficially, supposed to be phase 1 of 3.

NOTE: The plan also does a few odd things that likely won’t pass the Senate, these include provisions that make it so Planned Parenthood can’t be reimbursed for Medicaid. This provision is hidden beneath complex language like many other provisions in the bill.

Meanwhile, the MacArthur Amendment, the other part of what they are trying to pass as noted above, allows states to undo key ObamaCare protections at a state level.

This will, in many cases, result in Republican-led states being able to charge the sick and elderly more while giving younger and healthier people a break, in the name of “encouraging fair health insurance premiums.”

To offset the fact that the sick can be pushed out of the market on a state level, and to attract insurers to states to increase competition, it also creates a risk adjustment program (like ObamaCare had).

It does all of this via three waivers:

  • A waiver for community health ratings so the sick and elderly can be charged more,
  • A waiver for essential health benefits so states can exclude certain conditions for annual, lifetime, and other cost sharing limits, and
  • A waiver that allows for risk adjustment measures including an “invisible risk pool” which we explain below.

NOTE: The Amendment originally exempted Congress from the changes and allowed them to keep ObamaCare. However, this was changed (after drawing ire).

The Costs of TrumpCare 1.0

The plan (before the Amendment) had a price tag that came in under the ACA according to the Congressional Budget Officesaving $337 billion over the decade (according to their first report). However, it did this by leaving 52 million without coverage by 2026. It increases the uninsured by 24 million by 2026 for a total of 52 million.

Is This Like TrumpCare Promised on Trump’s Website?

Obviously that is “get rid of the mandates” as it says on Trump’s site, but that isn’t “insurance for everybody” and that isn’t “not letting them die in the streets.”

However, this is only supposed to be phase 1 of 3. No one knows what is coming next.

We will have more information once we find out if this version of TrumpCare 1.0 passes the house.

What do you think?

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bernice mitchell on

We eventually all get old and in need of repair often for no fault of our own. How did they get exempted and get the option of keeping ObamaCare? Do they think we are all stupid? We didn’t ALL vote for #45

Travis Rickards on

Bout time they get rid of the dang mandate.. most unamerican thing Ive ever heard of. F obama.

Jan Blesener on

Without insurance coverage I will not be able to provide myself with the medical attention I need. I have CHF, Lupus and myositis. Trumps plans don’t seem to care about people with existing illness. So for me this is like a death sentence.

Tom Murtha on

“you” originally stated the AHCA included a provision to have the value of employer plans taxed as ordinary income yet I do not see this in your lasted info. Has that provision been removed or is there still a hidden tax on employer plans to the employee?

ObamaCareFacts.com on

There was so many quick changes it is hard for anyone, even the hardcore wonks and congress to keep track. That said, I feel that what you are referring to is slated for “phase two or phase three.” This is only the first phase of the plan, although I would not suggest one holds their breath for the next phase. Have to see what happens here first.

We will be reviewing the bill again if and when the Senate has something passible ready (I don’t recall this that specific provision being in the new bill, but will 100% double check).