The American Health Care Act

On May 4 my colleagues in the House and I passed the American Health Care Act (AHCA). This legislation would repair our nation’s healthcare system by repealing failing provisions of the Patient Protection and Affordable Care Act (ACA), otherwise known as Obamacare, and replace it with a sustainable policy that actually addresses the needs of the American people. I am a firm believer in a patient-centered health policy that provides individuals with competitive choices, and Obamacare falls far short of that standard.

There is a lot of misinformation about this bill and what is in it. Don't be fooled, the American Health Care Act is our best chance to fix our nation's healthcare system and create policy that serves the needs of the American people for the long-term.

Frequently Asked Questions:

-Didn't Members of Congress exempt themselves and their staff from the ACHA?

No. Congressman Knight was an original cosponsor of H.R. 2192, which ensures there will be no exceptions for Members or Staff under the AHCA. Read the text of that bill here.

-Won't 24 million people will lose their health insurance under the AHCA?

No, in fact the AHCA will ensure that all Americans have access to affordable, quality health care now and for future generations. Unlike the ACA, which caused premiums to rise and mandated Americans to purchase one-size-fits-all insurance plans, the AHCA allows for monthly financial support for the purchase of private, individual health insurance that fits your needs.

-Won't the bill cause people with pre-existing conditions to lose their coverage?

Absolutely not. The AHCA clearly states that insurance companies cannot deny you coverage based on pre-existing conditions. States will have the ability to lower premiums and stabilize the insurance market by obtaining waivers for certain provisions if they establish programs to serve people with pre-existing conditions. Although California is not likely to obtain a waiver, Congressman Knight co-authored the Upton-Long Amendment to ensure that individuals in these states will have an extra layer of protection. 

Isn't this just a tax break for the wealthiest Americans?

The AHCA ends the taxes that the ACA imposed on all Americans. The ACA was incredibly expensive, and in order to pay for it taxes were raised on goods and services ranging from medical devices to prescription drugs to over-the-counter medicine. These were huge burdens on everyday working people, and the AHCA will deliver much-needed relief.

-Doesn't the bill cut Medicaid spending and hurt vulnerable Americans?

It does not. The AHCA will not kick a single person out of the Medicaid program, and does not place a cap on the benefits any individual can receive through Medicaid. Instead it gives states flexibility in how Medicaid funds are spent while requiring states to provide services to disabled and elderly individuals, who the program is intended to serve.

-Won't this bill caused healthcare costs for seniors to rise?

Just the opposite. The ACA discouraged healthy Americans from purchasing health insurance by placing costly restrictions on plans and raising taxes, which in turn drove up costs for older Americans. By repealing this harmful provisions and providing a tax credit to every American to purchase insurance, the AHCA will lower costs for everyone, especially seniors.

Want to learn more? Here is some background information.

The Problem: The ACA is failing, and it is only going to get worse.

In 2010 the ACA was passed without bipartisan support despite warnings by many that it was short-sighted and would quickly lead to the failure of our nation’s healthcare system. It did include many provisions that were beneficial to the American people, such as protections for individuals with pre-existing conditions and giving young people the option to stay on their parents’ plan until age 26.

Unfortunately the law fell far short of what was promised. Under the ACA Americans were promised that they could keep their current plans and their doctors. The law did the exact opposite- it placed one-size-fits-all regulations on insurance plans, limiting choices and driving up costs.
 
Americans were promised to see lower premiums under the ACA. This was not the case; since its passage, many families across the country have seen their premiums skyrocket. Rather than incentivize insurance companies to offer plans that fit the needs of Americans, the ACA forced Americans to buy health insurance by implementing the individual mandate - a tax on all Americans who chose not to purchase the overpriced plans that were being offered. Even with this tax, many Americans chose to pay their fine rather than spend money on insurance that they did not want.

It gets worse: Experts warn that the law is in a death spiral.

What does this mean? The ACA discouraged healthy Americans from purchasing health insurance by placing costly restrictions on plans and raising taxes. When healthy people pull out of the market, premiums are raised to cover the costs of less healthy patients. As more people are priced out of the market, insurers begin pulling out as well, decreasing competition and giving people fewer and fewer options for coverage. What this ends with is a situation in which Americans eventually have one or no options for care. We recently saw this happen in Iowa, where people in 94 of 99 counties will soon have zero options for healthcare in the ACA's exchange markets.  

While California’s healthcare marketplace, Covered California, is faring better than nearly any other state’s, it will not be shielded for long as the other state exchanges and the national Healthcare.gov continue their rapid, destructive decline.
 
Bottom line: If Congress does not act quickly, the ACA will collapse and millions of Americans will be left with no access to health insurance. This is unacceptable. 

The Solution: The American Health Care Act
My colleagues and I recently passed The American Health Care Act, or the AHCA. This legislation repeals the parts of the ACA that are failing and replaces them with a system that will be sustainable for generations to come.
-The AHCA repeals the taxes and regulations that drove up premiums and restricted choices for millions of Americans and replaces with a sustainable system that grants those without coverage a monthly healthcare credit to purchase an insurance plan that fits their needs.
-It empowers small businesses and relieves individuals by eliminating the individual and employer mandate penalties. 
-It ensures that Medicaid can continue to serve the core, vulnerable populations served it was designed to help, such as pregnant women, the aged, the blind, and the disabled.

The AHCA also preserves the parts of the ACA that are working
-It maintains protections for individuals with pre-existing conditions. I was proud to co-sponsor an amendment to the bill that would add an additional layer of protection to people with pre-existing conditions in states that choose to waive certain federal insurance regulations that increase insurance premiums.
-Young people will continue to have the option to stay on their family plans until age 26.

-It will allow Californians who are currently rely on Medi-Cal to continue receiving those benefits as long as they meet eligibility requirements and maintain continuous coverage.
-It protects access to care for women by continuing to prohibit insurance companies from charging higher on the basis of gender and funding Federal Qualified Health Care Service sites, which offer a wide range of affordable women’s healthcare services.

Don't take my word for it, read the full text of the American Healthcare Act for yourself.

Text of the American Healthcare Act


Text of the MacArthur Amendment


Text of the Upton-Long Amendment, of which I am a coauthor


Other Bills Congress has passed this Congress that effects Health Care

H.R.1304, the Self-Insurance Protection Act
H.R. 1304 clarifies that federal regulators cannot redefine “stop-loss” insurance as “health insurance coverage” under federal law. Specifically, the legislation amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act (PHSA), and the Internal Revenue Code to continue allowing employers to utilize stop-loss insurance coverage, a financial risk-management tool, when offering employees health care coverage through a self-funded plan. The bill does not restrict the regulation of stop-loss insurance at the state level.
Passed House, passed House 400-16, bipartisan

H.R. 1101, the Small Business Fairness Act of 2017
H.R. 1101 amends the Employee Retirement Income Security Act of 1974 to allow small businesses to join together in association health plans (AHP) across state lines through bona fide trade associations to become larger purchasers of health insurance. Specifically, the bill relieves small businesses that form AHPs from costly state-mandated benefit laws that often make coverage prohibitively expensive. H.R. 1101establishes a class certification for fully-insured AHPs prescribed by the Secretary of Labor. In addition, self-funded AHPs must meet certain criteria to insure the businesses covered will be of average health risk to avoid pulling healthy individuals from the small group market. Further, the bill contains protections to ensure self-funded AHPs meet and maintain solvency standards, such as maintaining a minimum of $500,000 in surplus reserves which are reviewed quarterly by the AHP’s board of trustees. Self-funded AHPs also will be required to obtain stop-loss and indemnification insurance coverage. 
The bill puts small businesses on an equal playing field with unions and larger corporations, enabling them to have a greater ability to negotiate lower health care costs for their employees.  In turn, this makes it easier for small businesses to offer their employees access to quality, affordable health care coverage.
Passed House, 236-175

H.R.372, the Competitive Health Insurance Reform Act of 2017
H.R. 372 amends a section of the McCarran-Ferguson Act of 1945 which exempted the insurance industry from antitrust laws (the Sherman Act and the Clayton Act). The Act ensures that health insurance issuers are subject to the same antitrust and unfair trade practices laws that all businesses have had to comply with. This would subject insurers to federal laws against price fixing, bid rigging, or market allocations to the detriment of competition and consumers. However, the antitrust exemption is retained for certain collaborative activities between health insurance businesses.
Passed House, 416-7, bipartisan

H.R.315, the Improving Access to Maternity Care Act
H.R. 315 requires the Health Resources and Services Administration (HRSA) to collect data to better place maternity health care professionals in existing primary care health professional shortage areas. Currently, maternity health care professionals can participate in the National Health Service Corps (NHSC) but they are not always placed where they are most needed. The bill will help better place maternity health care professionals in areas with the greatest need for their services. The National Health Service Corps (NHSC) places health care professionals who participate in their Loan Repayment Program, which requires a two-year commitment, in areas where HRSA finds health professional shortages. H.R. 315 is designed to more effectively allocate maternity health care providers who already participate in the NHSC Loan Repayment Program, in areas with higher need of maternity health care. The bill does not change or expand participation in the NHSC.
Passed House, 405-0, bipartisan

H.R. 1215, the Protecting Access to Care Act of 2017
H.R. 1215 reforms medical litigation laws where coverage was provided or subsidized by the federal government, including through a subsidy or tax benefit. Specifically, the legislation establishes a default $250,000 cap on noneconomic damages (the same as California law), limits the contingency fees lawyers can charge to maximize patient recovery, and establishes a fair share rule, by which damages are allocated in direct proportion to fault. The bill does not preempt any state law that limits damages at higher or lower amounts. To avoid bankruptcies, courts can require periodic payments for future damages instead of lump sum awards. The legislation requires full compensation for 100% of plaintiffs’ economic losses, including medical costs, lost wages, future lost wages, rehabilitation costs, and any other economic out-of-pocket loss suffered, and does not preempt certain other state laws and federal vaccine injury laws and rules.
Passed House, 218-210

Senate Version Announced on June 22, 2017

On the morning of June 22, 2017, the U.S. Senate Republicans released the following companion health care bill. This bill has five components to it: help stabilize collapsing insurance markets that have left millions of Americans with no option, free the American people from the onerous Obamacare mandates, improve the affordability of health insurance, preserve access to care for Americans with pre-existing conditions, and strengthen Medicaid.

To read a brief description on the bill from the Senate Committee on the Budget CLICK HERE

Text of the Senate Republican Health Care Bill


Final Note

My office and I are committed to serving residents of California's 25th Congressional District.  If you have any questions about this legislation or would like further explanation of why I support it, please send an email here. 

If you or a loved one is experiencing difficulties with a federal agency or program such as the Medicare, Medicaid, the Department of Veterans Affairs, or Social Security, please fill out a casework form here and our team will get to work to assist you.

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