FEDERAL | AHCA Amendments Leaked Before Congress Returns from Recess

President Trump is committed to showing progress on health care within his first 100 days, a promise he made repeatedly on the campaign trail, which has prompted Republican leaders to revise their initial proposal to repeal and replace parts of the Affordable Care Act (ACA). Rep. Tom MacArthur (R-N.J.), head of the moderate Tuesday Group, has offered amendments to that proposal, the American Health Care Act, that attempts to appease both the far-right House Freedom Caucus and moderate Republicans.

The MacArthur Amendment would maintain many of the most popular elements of the ACA, including coverage for emergency services and maternity care. It would also prohibit discrimination based on gender and permit dependents up to age 26 to remain on their family plan.

The amendment would create an option for states to obtain limited waivers from certain federal standards, in the interest of lowering premium costs and expanding the number of insured persons. While the amendment maintains coverage for those with preexisting conditions, the waiver would allow carriers to increase premiums for these patients as long as high-risk pools are also made available. The plan also reinstates the federal requirements for essential health benefits, although states could seek permission through the waiver to develop their own set of essential health benefits.

In order to be eligible for the limited waiver, states must confirm that the purpose of their requested waiver is to reduce premium costs, increase the number of patients with coverage, or advance another benefit to the public interest in the state. The Secretary of the Department of Health and Human Services, former Rep. Tom Price, MD, will be responsible for reviewing and approving applications.

MacArthur is working closely with House Freedom Caucus Chairman, Rep. Mark Meadows (R-N.C.), in an effort to unite the party in advance of a vote in the House. Yet it still remains unclear as to whether Republicans will succeed their second time around in passing ACA repeal legislation.