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American Health Care Act

Bill Number: HR-1628

Disposition: 2019-Jan-02
Passed House, Failed in Senate

The bill will not become law.

Full title...
A bill to provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017.

Click to view...
Bill Text (Reading difficulty: Hard)
Vote (House)
More Information

Sponsor & Key Contributors
Lindsey Graham (Graham-Cassidy amendment)
William Cassidy (Graham-Cassidy amendment)

Related Issues...
Repealing (and Replacing?) Obamacare

Related News...
Senate fails to pass ObamaCare repeal

Other names for this bill

This bill often is referred to as the AHCA (acronym for American Health Care Act).

Because of the complicated way this bill has been discussed and modified in both the House of Representatives and the Senate, we are documenting three versions.

This version is the bill the Senate agreed on July 25 to debate. It is the only version that has a chance to become law. It started as a copy of the bill passed by the House. However, it was expected to undergo many changes - possibly involving a complete replacement. The changes will be made via proposed amendments - each of which will be voted on.

The other two were preliminary ones considered by each house of Congress...

o The version originally passed by the House of Representatives - the American Health Care Act (AHCA).

o The version originally considered by the Senate, named the Better Care Reconciliation Act (BCRA). It did not receive enough support in the Senate to pass. For all practical purposes, it is considered to be dead.

Because the original version can be seen in the version passed by the House, we only will document the amendments.

Whatever is passed by the Senate (assuming something passes), it will need to be reconciled with the House through a conference committee.

Several unusual paths were taken

This bill was intended to repeal and replace parts of the Patient Protection and Affordable Care Act (ObamaCare).

Both the House and Senate versions were written in an unusual way, in that they bypassed the normal process of being approved by a Congressional committee before being debated by the entire House or Senate. This time, however, both versions were introduced and then subject to changes without really having a clear agenda for a national health care policy.

Senate Republicans were using the budget reconciliation process in order to pass this bill without making it subject to a filibuster.

However, after Amendment 667 - the skinny repeal - failed to pass, Senate Majority Leader Mitch McConnell removed the entire bill from consideration. It still remains active and can be reconsidered at any time McConnell chooses, but it is expected to remain dormant for the immediate future.

This bill expired when the 115th Congress ended in Jan. 2019.

This amendment would gut Obamacare

This amendment was called a clean repeal. It simply repeals key parts of Obamacare.

It is a near-duplicate of the Obamacare repeal bill that Congress passed in 2016 but was vetoed by President Barack Obama.

Provisions would be phased in over two years, ostensibly to give Congress time to come up with an alternative health care policy.

This amendment was submitted by submitted by Rand Paul. It was rejected.

The single payer ruse

This amendment would have replaced the entire text of the bill with one that would have created a single-payer health care system.

It is identical to the Expanded & Improved Medicare For All Act submitted in the House of Representatives by Rep. John Conyers.

Though no Republicans are on record as supporting a single-payer system, this amendment was submitted by Steve Daines - a Republican.

Every Republican - including Daines - voted against it. So they knew it would fail when they proposed it. The amendment simply was an attempt by Senate Republicans to get Democrats on the record for supporting a single-payer system.

Eliminating the tax on expensive employee insurance

This amendment would permanently eliminate the Cadillac Tax - the tax on high-end health insurance plans that some companies offer employees in lieu of a higher salary.

This amendment was submitted by Dean Heller. It was approved.

Because the overall bill did not pass, this amendment will have no effect even though it was approved. The Cadillac Tax still is scheduled to take effect in 2020.

Simply eliminating the requirement to have insurance

This amendment would have replaced the entire bill with an 8-page bill referred to as the skinny repeal.

Had this amendment been approved, the bill would have kept the bulk of Obamacare in place. It would have...

o Eliminated the mandate for individuals to have heath care insurance.

o Eliminated the requirement for employers to provide health care insurance.

o Stopped funding for Planned Parenthood.

This amendment was submitted by Mitch McConnell. It was rejected.

Replacing Obamacare with block grants to States

This amendment (in effect a full bill) would replace ObamaCare with grants given to states. It would...

o Eliminate The Mandate - the requirement to have health care coverage.

o End the subsidies that help people afford insurance policies.

o End Cost Sharing Reduction Subsidies that help insurance companies reduce out-of-pocket expenses for those with low incomes.

o End Medicaid Expansion.

These benefits of ObamaCare would be replaced with block grants given to states.

Each state would effectively be free to use the money to set up any type of health care it wanted. This includes eliminating the requirement that policies cover essential health benefits such as preventive care or maternity care, as well as allowing insurance companies to charge more for someone with pre-existing conditions.

Catastrophic plans - low cost plans with high deductibles and few benefits - would be available to anyone. Under Obamacare they are only available to those under age 30.

Policies would not be allowed to cover abortions. And funding for Planned Parenthood would be eliminated.

The amount someone could contribute to a Health Savings Account would be increased.

Some of the taxes that help pay for Obamacare, such as the Medical Device Tax, would be eliminated.


The Skinny Repeal amendment was rejected by the Senate on July 28, 2017.

This effectively killed the bill.

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