The American Health Care Act
Frequently Asked Questions (FAQs)
Q: Does this legislation apply to Members of Congress and their staff?
A: Yes. Members of Congress should abide by the laws they create. The House passed legislation that ensures the American Health Care Act and its amendment apply to everyone.
Q: Will the AHCA as amended do away with protections for those with pre-existing conditions?
A: Under no circumstance can people be denied coverage because of a pre-existing condition. Current law prohibiting pricing customers based on health status remains in place and can only be waived by a state if that state has chosen to take care of the people through other risk-sharing or reinsurance mechanisms. Even if a state asks for, and is granted a waiver, no person may be priced based on health status if they have maintained continuous health coverage.
Current law prohibiting pricing customers based on health status remains in place and can only be waived by a state if that state has chosen to take care of the people through other risk-sharing or reinsurance mechanisms. Even if a state asks for, and is granted a waiver, no person may be priced based on health status if they have maintained continuous health coverage.
Q: Is the AHCA's continous coverage provision just a more harmful, less effective mandate?
A: Unlike Obamacare, our plan does not allow the IRS to fine Americans for choosing not to buy government-approved care. The IRS should not be policing your health care.
In order to prevent gaming of the system and help keep premiums lower for everyone, our plan would allow carriers to charge a flat, one-time, 30% surcharge on top of a premium only if an individual has not maintained continuous coverage.
The continuous coverage provision is important to ensure individuals cannot unfairly game the system and pay for coverage only when they have medical bills. Individuals can go without coverage for sixty-three days and still maintain continuous coverage status.
The vast majority of Americans who get health care from their employers already receive continuous coverage protections. Medicare Parts B and D also use a form of continuous coverage protections. We are extending a similar provision to the individual and small group markets in order to prevent gaming of the system and incentivize people to get - and stay - enrolled.
Q: Can young adults stay on their parents healthcare plan until their 26?
A: Yes. The AHCA helps young adults obtain access to health insurance and stabilizes the marketplace by allowing dependents to continue staying on their parents' plan until they are 26.
Q: Does the AHCA lift the ban on lifetime caps?
A: No. The AHCA preserves the ban on lifetime caps.
Q: Doesn't the AHCA kick millions of people off of Medicaid?
A: The Medicaid program today is a critical lifeline for some of our nation’s most vulnerable patients. But the program now has three times as many people and costs three times as much as it did under former President Clinton. By expanding Medicaid, Obamacare prioritized able-bodied adults above those the Medicaid program was originally designed to help. We will not pull the rug out from anyone as we work to give states the flexibility they need to take care of those most in need.
Our plan responsibly unwinds Obamacare’s Medicaid expansion. We freeze enrollment and allow natural turnover in the Medicaid program as beneficiaries see their life circumstances change. This strategy is both fiscally responsible and fair, ensuring we don’t pull the rug out on anyone while also ending the Obamacare expansion that unfairly prioritizes able-bodied working adults over the most vulnerable.
Q: Aren't you pulling the rug out from under low income Americans by ending the Medicaid expansion?
A: All those currently enrolled under the Medicaid expansion are grandfathered in. This means they will remain enrolled in the program if they continue to meet the current eligibility requirements and expansion states, like Michigan, would continue to receive the enhanced match under current law for existing beneficiaries.
Q: Under the AHCA, will mental health parity go away?
A: This legislation does not change mental health parity rules.