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Updates on Replace and Repeal of the ACA: American Health Care Act Sent to the Senate

May 10, 2017 | Leave a Comment

AHCA sent to senate

On May 4, the U.S. House of Representatives voted to repeal the 2010 Affordable Care Act and replace it with the American Health Care Act. The new bill is now being deliberated by the Senate.

Although there is much media coverage surrounding the bill, all ACA requirements will remain in effect until the AHCA is passed by the Senate and signed into law by President Trump.

As the Senate considers the AHCA as it has been passed by the House of Representatives, it may pass or dismiss the bill in its entirety – or it could change the legislation so much that it passes a drastically different bill.

If the House and the Senate do pass separate versions of the bill, a committee will be formed to compromise and draft a hybrid of both bills. If a committee produces a hybrid bill, the Constitution requires that both the House and the Senate pass identical versions of the bill before it can be signed into law by President Trump.

This process may take weeks or months.

If it was signed into law as it stands now, the AHCA would make the following revisions to the ACA:

How will this affect your employer health plan?

  • Employer shared responsibility rules—

The ACA’s employer shared responsibility rules require applicable large employers (employers with 50 or more full-time employees) to offer an acceptable minimum level of health coverage to full-time employees and their dependents – or pay a penalty. Under the new bill, this provision will be canceled. However, Form 1094 & 1095 reporting requirements will remain.

  • Federal subsidies for small businesses—

In 2020, the ACHA will repeal the ACA’s small business tax credit.

  • Relief from Cadillac tax—

The start date of the excise tax on high-cost employer-sponsored health plans will be pushed back, so the tax will begin after Dec. 31, 2025.

How will this affect your employees?

  • Increases in HSA contribution limits—

The ACHA will increase the maximum Health Savings Account contribution limit beginning in 2018. Where the maximum out-of-pocket limit allowed by law is currently $3,400 for self-only and $6,750 for family coverage, the ACHA will increase those maximums to $6,550 and $13,1000 respectively.

  • HSAs covering prior expenses—

Under the new bill, HSA funds will be able to pay for health care expenses incurred prior to the start date of the HSA (at least for funds occurring after the start date of a high deductible health plan, given the HSA is opened within 60 days from the start date of the HDHP).

  • OTC medications—

Tax-advantaged HSAs will be able to be used for a wider variety of over-the-counter health purchases.

  • FSA limits—

The ACHA will repeal the ACA’s clause imposing a limit to the funds an individual can contribute annually to a health Flexible Spending Account.

How will this affect the health care exchange?

  • Individual mandate—

The ACA requires most individuals to obtain acceptable health insurance coverage for themselves and dependents or pay a penalty. Under the AHCA, this mandate will be repealed. Instead, the ACHA will impose a 30 percent penalty onto the premiums of small groups and individuals that have lapses in coverage.

  • Federal subsidies for individuals—

The ACA currently offers tax credits to low-income individuals who purchase health care coverage through the exchange. The AHCA will repeal these credits in 2020 and replace them with a monthly tax credit for all individuals.

Things that will not be changed by the ACHA include that coverage will still be allowed for children up to the age of 26 and there will be guaranteed availability and renewability of coverage.

Click here to read the American Health Care Act.

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