Summary of the American Health Care Act Bill

News | Published: Friday, May 5, 2017 5:00 am


On May 4th, the American Health Care Act (AHCA) passed the House of Representatives (217-213), which now goes to the Senate. Major provisions of the AHCA bill include:

  • Reduce government spending, mostly by cutting subsidies currently included in the Affordable Care Act (ACA)
  • Reduce the number of people that qualify for Medicaid
  • Repeal the individual and employer mandates requiring health coverage or face a tax penalty
  • Allow states to apply for waivers to change the mandate for covering pre-existing conditions and to change the definition of the essential benefits mandated in insurance coverage
  • Add funding over five years to “high-risk” pools meant to offset the higher insurance costs of covering those with pre-existing conditions
  • Change Medicaid funding to include federal block grants to States
  • Restore Medicaid Disproportionate Share Hospital Payments in 2018 or 2020, depending if the State expanded Medicaid under the ACA

There currently is no Congressional Budget Office (CBO) score on this version of the ACHA bill, which means there is no official savings figures nor the estimated number of people who may lose health coverage. 

The next step in the process is that the bill goes to the Senate. It is anticipated the Senate will introduce their own version of the bill, which will require reconciliation with the House version. In essence, this means there is still a long way to go before a final version of the ACHA can be signed into law by the President. 

From a cardiovascular perspective, at a high level we believe the impact of ACHA will be limited as it does not significantly impact Medicare beneficiaries. The focus of the bill is on insurance coverage for non-Medicare patients, particularly those with employer-based insurance and Medicaid.

However, the true impact to the CV service line, physicians, hospitals, patients and others is unclear until the Senate provides information on its version of the AHCA bill, and what is ultimately reconciled with the House of Representatives. 

We will continue to monitor what occurs on Capitol Hill regarding AHCA (as well as other major legislative actions that may impact cardiovascular services) through our resources in Washington DC and elsewhere, and provide updates as warranted.

More information on what is included in the recently passed ACHA bill can be found at


Patrick Holloway
COO, Oklahoma Heart Hospital Physicians
President, Cardiology Advocacy Alliance

Patrick White
President, MedAxiom



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