PCG creates summary of the House-passed health care bill

Lisa Kaplan Howe on May 5, 2017

The American Health Care Act (“the bill”) passed the House of Representatives on May 4, 2017. As outlined in greater detail in the PCG summary, the bill does not repeal the Affordable Care Act (ACA) in full, but rather proposes changes primarily focused on the ACA’s insurance affordability, Medicaid expansion, coverage requirements and revenue provisions. It also proposes changes to Medicaid funding more generally and allows states to waive medical underwriting prohibitions.
Prior to passage, the following amendments to the bill were adopted:
  • Two Manager’s Amendments which would: allow states to receive a block grant in lieu of per capita funding for Medicaid and adopt Medicaid work requirements; expand use of and funding for the Patient and State Stability Fund; amend various effective dates and make other technical amendments; and create a Federal implementation fund.
  • Invisible Risk Sharing Amendment which would create and provide funding for a Federal prospective reinsurance program.
  • MacArthur Amendment which would allow for state waivers of age rating limitations; Federal essential health benefits; or underwriting prohibitions.
  • Upton Amendment which provides funding for states that waive underwriting prohibitions to lower premiums or cost-sharing for impacted individuals.
PCG subject matter experts have created a comprehensive overview of the bill as passed by the House.
Please contact us at healthpolicynews@pcgus.com for more information.

Published by Lisa Kaplan Howe

Lisa Kaplan Howe (J.D.) is a Senior Advisor who has spent her career working in health law and policy. At PCG, she focuses on statutory and regulatory analysis and strategic advising, particularly related to health care policy. Lisa has provided subject matter expertise to support state health care reform efforts, including policy development and regulatory support for health insurance Marketplaces and state insurance plan management efforts, Medicaid expansion and Medicaid Waivers (including DSRIP Waivers) and State Innovation Waivers. Lisa led PCG’s work with the New Hampshire Insurance Department relative the state’s Section 1115 Medicaid Waiver to provide coverage to newly-eligible adults through the Marketplace and continues to support the states’ Marketplace plan management work. In those roles, Lisa has served as the chief advisor and policy expert related to Medicaid and private insurance law to the New Hampshire Insurance Department, helping to identify, analyze and lead strategic consideration of federal opportunities and requirements. Lisa is also part of the team helping to design Colorado’s Delivery System Reform Incentive Payment (DSRIP) program. Ms. Kaplan Howe also provides broad policy and regulatory support to PCG’s other health care clients across the country, analyzing policy and regulatory developments, providing strategic advice relative to regulatory questions, and drafting policy briefs and position papers. Lisa is a managing editor of PCG’s monthly health practice area newsletter, Health Policy News. Prior to joining PCG, Lisa served as Policy Director at New Hampshire Voices for Health, where she led legislative and regulatory analysis, strategic planning, and implementation of the organization’s policy agenda. Her work included drafting bills, amendments, testimony, and communications and testifying at hearings. Lisa also held the positions of Private Market Policy Manager and Consumer Health Policy Coordinator at Health Care for All of Massachusetts. While there, she managed private insurance market policy work and was a member of the organization’s internal health reform team. Lisa also practiced law in the Ropes & Gray health care department, advising health care provider and insurer clients.

  1. Health Policy News June 2017 – Health Policy News Blog July 16, 2018 at 9:30 pm

    […] Click here to continue reading about the AHCA, including details of the amendments made prior to the bill’s passage by the House, as well PCG’s comprehensive overview of the AHCA. […]

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