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Congressman Dave Trott

Representing the 11th District of Michigan

Health Care

Rep. Dave Trott is fighting for patient-centered health care reforms that strengthen the doctor-patient relationship, lower the costs of health care for Michigan families, and eliminate the big-government mandates imposed by Obamacare.

Since coming to Congress, I have supported replacing the Affordable Care Act (Obamacare) with a market-based plan that reduces costs and provides better care for the American people. 

Back in 2009, the American people were promised health premiums would decline by $2,500 per family, but the average premium has actually gone up and the average family's employer-sponsored health care plan now costs more than $18,000 a year. In Michigan, premiums for individuals are expected to climb nearly 17% in 2017. Last year alone, we saw deductibles increase an average of $492 across all plans on the Obamacare exchange.

What I have heard from many families and small businesses in Southeast Michigan is that this top-down, Washington-centered approach to health care has not worked. Citizens that I represent have told me concerns regarding increasing premiums, higher taxes, fewer choices, and less access to care. 

That's why I supported the American Health Care Act and additional legislation that requires Members of Congress to live under the American Health Care Act, ensuring there are no exemptions for Members or their staff. 

After carefully reviewing the American Health Care Act and the amendments made to the bill, I believe this legislation makes several key improvements, such as:  

  • Eliminates the individual and employer mandate penalties, which forced millions of workers, families, and job creators into expensive, inadequate Obamacare plans that they don't want and cannot afford.
  • Dismantles the Obamacare taxes that have hurt job creators, increased premium costs, and limited options for patients and health care providers. 
  • Guarantees coverage to Americans with pre-existing conditions and bans health insurers from charging a patient with pre-existing conditions higher premiums as long as they maintain continuous coverage, or sign up for new coverage within 63 days of exiting a previous insurance plan.
  • Helps young adults access health insurance and stabilize the marketplace by allowing dependents to continue staying on their parents' plan until they are 26.
  • Modernizes and strengthens Medicaid so states can better serve Michigan patients most in need. 
  • Empowers individuals and families to spend their health care dollars the way they want and need by enhancing and expanding Health Savings Accounts (HSAs).
  • Help Americans access affordable, quality health care by providing a monthly tax credit-between $2,000 and $14,000 a year-for low-and middle-income individuals and families who don't receive insurance through work or a government program. 

The American people send their lawmakers to Washington to make tough choices - not to be obstructionists, but to work toward substantice solutions. While this legislation is not perfect, I am committed to continuing to work with my colleagues and the President to improve our nation's health care system. 

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 I cosponsored 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 continuous 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 parent's 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: Does the AHCA do away with critical Essential Health Benefits, such as coverage for maternity care?

A: Under the AHCA plan, the 10 Essential Health Benefit Categories would remain the federal standard. States could seek a waiver to establish new benefit standards, but subject to certain conditions: the state must publicly attest its purpose for doing so (to reduce the cost of healthcare coverage, increase the number of people with healthcare coverage, etc.) and it must specify the benefits it will require instead of the federal standard. 

Q: Under the AHCA, will mental health parity go away? 

A: This legislation does not change mental health parity rules. 

Q: The CBO says the AHCA increases the number of uninsured by 24 million people. Is this true?

The CBO has a spotty track record when it comes to projecting health insurance coverage. When CBO originally scored Obamacare, they projected that 21 million Americans would have coverage in 2016. The reality was half that number, about 10.4 million gained coverage. 

Our plan provides every American with access to affordable coverage. Low-income individuals not on Medicaid will receive a refundable tax credit to purchase insurance (meaning they get assistance even if they do not pay income tax). States can also further help low-income Americans through a new Patient and State Stability Fund. 

The majority of the coverage gains from Obamacare come from the law’s individual mandate – a fine from the federal government for failing to buy government approved coverage. But evidence shows that the CBO greatly overestimated the effectiveness of the individual mandate and the numbers of Americans who would receive coverage through the exchange. 

In fact, more than 19 million taxpayers either paid the penalty or claimed an exemption from the individual mandate. More people are paying or avoiding the penalty than gained coverage through Obamacare’s exchanges. 

Q: Will Republican health care proposals cause premiums to spike for Americans across the country? 

A: Obamacare has caused premiums to skyrocket across the nation, up about 25 percent on average this year. Ask a middle-class American what’s has happened to their premiums and their deductibles. Enormous increases have left many families paying for insurance that they cannot afford to use. 

The Obama administration has effectively locked in more expensive plans for both this year and next year, sneaking in the 2018 coverage mandates three days before President Trump took office. Obamacare is in a death spiral and it will take some time to pull out of it. 

The AHCA will lower premiums over time by an average of 10% - and potentially more as further reforms are made and new and innovative ideas implemented that aim to lower premiums. 

Q: Will repealing Obamacare cause chaos in the health care markets? 

A: Obamacare has been the definition of chaos from the very beginning. Hard-working American families have fewer choices than ever before, and costs continue to skyrocket as insurers flee the failing Obamacare marketplaces. Five entire states will have only one insurer – Alabama, Alaska, Oklahoma, South Carolina, and Wyoming. Even worse, one third of U.S. counties have only one insurer this year. Only five of the 23 CO-OPs remain in business, wasting billions in hard-earned taxpayer dollars. Obamacare has failed and the middle-class people are stuck paying higher costs. We are here to clean up the mess and rebuild our health care system a Better Way. 

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Q: Is the AHCA's continuous 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: Does the AHCA do away with critical Essential Health Benefits, such as coverage for maternity care?

A: Under the AHCA plan, the 10 Essential Health Benefit Categories would remain the federal standard. States could seek a waiver to establish new benefit standards, but subject to certain conditions: the state must publicly attest its purpose for doing so (to reduce the cost of healthcare coverage, increase the number of people with healthcare coverage, etc.) and it must specify the benefits it will require instead of the federal standard. 

Q: Under the AHCA, will mental health parity go away? 

A: This legislation does not change mental health parity rules. 

Q: The CBO says the AHCA increases the number of uninsured by 24 million people. Is this true?

The CBO has a spotty track record when it comes to projecting health insurance coverage. When CBO originally scored Obamacare, they projected that 21 million Americans would have coverage in 2016. The reality was half that number, about 10.4 million gained coverage. 

Our plan provides every American with access to affordable coverage. Low-income individuals not on Medicaid will receive a refundable tax credit to purchase insurance (meaning they get assistance even if they do not pay income tax). States can also further help low-income Americans through a new Patient and State Stability Fund. 

The majority of the coverage gains from Obamacare come from the law’s individual mandate – a fine from the federal government for failing to buy government approved coverage. But evidence shows that the CBO greatly overestimated the effectiveness of the individual mandate and the numbers of Americans who would receive coverage through the exchange. 

In fact, more than 19 million taxpayers either paid the penalty or claimed an exemption from the individual mandate. More people are paying or avoiding the penalty than gained coverage through Obamacare’s exchanges. 

Q: Will Republican health care proposals cause premiums to spike for Americans across the country? 

A: Obamacare has caused premiums to skyrocket across the nation, up about 25 percent on average this year. Ask a middle-class American what’s has happened to their premiums and their deductibles. Enormous increases have left many families paying for insurance that they cannot afford to use. 

The Obama administration has effectively locked in more expensive plans for both this year and next year, sneaking in the 2018 coverage mandates three days before President Trump took office. Obamacare is in a death spiral and it will take some time to pull out of it. 

The AHCA will lower premiums over time by an average of 10% - and potentially more as further reforms are made and new and innovative ideas implemented that aim to lower premiums. 

Q: Will repealing Obamacare cause chaos in the health care markets? 

A: Obamacare has been the definition of chaos from the very beginning. Hard-working American families have fewer choices than ever before, and costs continue to skyrocket as insurers flee the failing Obamacare marketplaces. Five entire states will have only one insurer – Alabama, Alaska, Oklahoma, South Carolina, and Wyoming. Even worse, one third of U.S. counties have only one insurer this year. Only five of the 23 CO-OPs remain in business, wasting billions in hard-earned taxpayer dollars. Obamacare has failed and the middle-class people are stuck paying higher costs. We are here to clean up the mess and rebuild our health care system a Better Way. 

More on Health Care

October 5, 2017 Press Release
In our nation’s hospitals, technology has helped provide better quality and more efficient health care, but the perpetual evolution of technology – its greatest strength – is also its greatest vulnerability. Since 2009, the health care data of over 127 million Americans has been compromised by cyber criminals, and existing security frameworks continue to leave this information vulnerable by failing to adapt to technological innovation.
September 15, 2017 Press Release
All those involved in committing these horrendous crimes against innocent children, must be held accountable for their unconscionable actions. We must protect our girls, and this legislation increasing the federal penalty is critical to eradicating this barbaric practice from our communities.
May 4, 2017 Press Release
The American Health Care Act instills patient-centered reforms that will reduce costs and includes safeguards for patients with pre-existing conditions, and allows young adults to stay on their parents' healthcare plan until age twenty-six. Additionally, this legislation modernizes and reforms Medicaid, protecting it for our children, the elderly, and the disabled, ensuring the program's future solvency.
May 3, 2017 Press Release
This bill supports our servicemen and women who put their lives on the line each and every day by providing our troops with the resources they need to safely and effectively do their job. Furthermore, when our troops return home, it provides them with the benefits and high-quality medical care they earned.
May 2, 2017 Press Release
In our nation’s enviable democracy, no one is above the law. Members of Congress must abide by the laws they create, and, as we work deliberately to improve our nation’s healthcare system, we must ensure that all Americans, constituents and Congress alike, have access to the same high-quality care. Anything less undermines the principles for which our nation stands.
March 1, 2017 Press Release
We need to protect and strengthen Medicare and the Medicare Advantage program so we can keep our promise to our seniors and ensure their access to reliable health care.
February 28, 2017 Press Release
We need to make health care work for everyone. We need to make health care more affordable, provide greater access to quality healthcare, while protecting patients with pre-existing conditions' access to the health care they need.
July 7, 2016 Press Release
"This is a serious bill that has critical reforms to help individuals and families who are quietly struggling with mental illnesses."
July 7, 2016 Press Release
“Congress must take bold action to address America’s opioid epidemic and make sure those struggling with addiction get the resources they need."
July 10, 2015 Page

The 21st Century Cures Act (HR 6)