On Thursday, May 4, the U.S. House of Representatives voted to approve The American Health Care Act (AHCA), an updated bill to repeal and replace various provisions in the Affordable Care Act (ACA). The vote passed by a margin of 217 to 213 along party lines. The bill now moves to the Senate where it is likely to go through significant debate and change before the Senate votes. It’s too early to know whether this bill will make it through the Senate and eventually be signed into law.
For now, the ACA remains in effect, and employers are required to continue to follow the provisions, even those that the AHCA proposes to repeal. These provisions include the employer mandate (known as Employer Shared Responsibility, or ESR), the individual mandate, and employer filing requirements.
The next step in the Senate involves the complex rules associated with budget reconciliation. Republicans have a majority of 52 to 48 in the Senate, with an additional vote by the Vice President in case of a tie. If the bill has no support by Democrats and loses the support of 3 Republicans, it would not pass under budget reconciliation rules. If the bill’s various provisions do not qualify under budget reconciliation, it would need 60 votes to pass. This complicated process will make the bill’s journey through the Senate more difficult. In addition, some Republican senators have expressed concern with the legislation in its current form; this factor, combined with budget reconciliation hurdles, will almost certainly result in major changes to the bill. Any changes would need to be reconciled with the House, and ultimately both chambers would need to agree to the legislation in its final form.
Further complicating this process, the Congressional Budget Office (CBO) has not released the updated score of the AHCA’s impact on both the budget and the projected coverage levels associated with various populations. The Senate will have to contend with the results of this score as it debates the legislation.
We will keep you informed about the bill and any other changes to the ACA that might affect our clients’ businesses.