Top ACA-repeal takeaways from the week: 1) AHCA passed in the House by a 217-213 vote; 2) The McSally Amendment, which prevent Members of Congress and their staff from being exempt from the State waiver provisions of AHCA passed in the House by a 429-0 vote; 3) the Senate has made clear they will write their own bill and take their time; 4) OMB Director Mulvaney is unsure if CSR payments will continue beyond May.

American Health Care Act –

On May 4, the House passed the American Health Care Act (AHCA) by a 217-213 vote with 20 Republicans voting against the bill and 0 Democrats voting in favor of it.  Republicans garnered support the past couple weeks with the inclusion of two major amendments:

  • The MacArthur amendment allows states to waive essential health benefits, age rating, and community rating. Health insurers would not be allowed to deny coverage based on gender or preexisting conditions, and states must explain how the waiver will reduce average premiums for patients, increase enrollment for residents, stabilize the state’s health insurance market, stabilize premiums for individuals living with preexisting conditions, or increase patients’ health plan options.
  • The Upton amendment increases the Patient and State Stability Fund by $8 billion. This fund gives states with an approved waiver, as established by the MacArthur Amendment, support to fund risk pools or reinsurance for patients with preexisting conditions.

The bill, as amended, has not yet received a score from the Congressional Budget Office.

Additionally, the House passed by a 429-0 vote the McSally Amendment (H.R. 2192), which would eliminate the exemption of Congress from the AHCA.

Though it is unclear what actions the Senate will take on the AHCA, shortly after the House passed the AHCA, Sens. Heller (R-NV) and Portman (R-OH) both released statements indicating that they would not support the bill in its current form. Senator Rand Paul is also opposed to the bill in its current form.

Cost-Sharing Reduction Payments

While the Trump Administration has previously said that they will continue cost-sharing reduction (CSR) payments, White House budget director Mulvaney told reporters at a briefing this week that he is unsure of whether they will continue. A spokesman for Mulvaney later clarified, indicating that May’s payments would be made but no decisions have been made beyond that.

FY 2017 Appropriations

The FY 2017 spending package passed both the House and Senate this week. The bill will now be sent to President Trump’s desk to sign into law. The bill included notable provisions, such as allocating funding for Puerto Rico’s Medicaid program and no inclusion of CSR payments.