The U.S. House of Representatives plans to vote on an updated version of the American Health Care Act (AHCA) today, May 4, after key Republican holdouts changed their votes from "no" to "yes."
In a meeting with President Trump the morning of May 3, Reps. Fred Upton (R-Mich.) and Billy Long (R-Mo.) agreed to vote for the AHCA after securing a new amendment intended to alleviate concerns around pre-existing conditions. Speaker Paul Ryan (R-Wisc.) is eager to hold the vote on the House floor before Congress goes on recess next week.
The amendment would add $8 billion over five years to high-risk pools, through which states can subsidize more expensive premiums for people with pre-existing conditions. This translates to $36 million per year per state, which may not be enough to cover the costs of premiums for these individuals. Additionally, studies have shown that high-risk pools can result in increased costs, decreased benefits and longer waiting lists.
This change follows an amendment from Reps. Mark Meadows (R-N.C.) and Tom MacArthur (R-N.J.) that would allow states to opt out of Affordable Care Act insurance rules, including minimum coverage requirements, and allow insurers to charge more based on an individual's health.
These changes to the AHCA fail to address NACo's overarching concern with how the bill would massively weaken the federal-state-local partnership that underpins our nation's health care system and shift federal and state costs to counties. Under the AHCA, the federal government would cut Medicaid spending by over $800 billion over the next 10 years. The Congressional Budget Office estimates that 24 million individuals, including 14 million Medicaid beneficiaries, would lose health insurance coverage.