ACA to AHCA Comparison by Insurance Type

​Insurance Type	​Who is impacted	​Benefits with ACA	​What would be lost with AHCA	​To Learn More
​Individual insurance market	Adults who are not insured through work or are unemployed	Healthcare.gov or state exchanges to buy insurance online with subsidies to help pay premiums based on income.  Private insurance rules:  Plans must cover benefits such as maternity, mental health, and prescription drugs.  Cannot charge higher premiums based on age. Cannot deny pre-existing conditions.  No lifetime limits Free preventative screenings and contraceptives	ACA cost sharing subsidies are repealed effective January 1, 2020. Starting in 2020, replace ACA income-based tax credits with flat tax credit adjusted for age.  ​ Private insurance rules:  States can opt out of a rule that requires insurance companies to offer essential benefits in their plans; and provision that bars insurers from charging people with pre-existing conditions more money than healthy people.	Kaiser Family Foundation What’s in the House GOP health care bill?   Private Insurance - Kaiser
Medicaid	Low income adults (includes those who are mentally ill, disabled, or elderly)	Maintains Medicaid as a federal-state matching program Allows states to expand Medicaid to:  Increase eligibility to nearly all low income adults with incomes at or below 138% FPL  Streamline eligibility and enrollment  Increase options and funding for delivery system innovation, including expanded options for community-based long-term care.	Change existing federal funding for states to block grants which means the Medicaid program cannot expand to meet state need (per capita allotment). Ends Medicaid expansion  Create state option to require work as a condition of eligibility for nondisabled, nonelderly, nonpregnant enrollees Prohibit federal Medicaid funding for Planned Parenthood clinics	Medicaid Pocket Primer   Medicaid’s Future - Kaiser
Medicare	Older adults 65+ and the disabled	Lower Part B premiums Free preventative care and annual wellness visit Closing “donut hole” for drug coverage by 2020 Reduced payments to Medicare Advantage plans	​Reductions to Medicare provider payments and Medicare Advantage payments are not changed AHCA would repeal the Medicare payroll surtax on high-income earners. Repealing this surtax would reduce revenue to the Medicare Hospital Insurance (Part A) trust fund by $117 billion between 2017 and 2026	National Committee to Preserve Medicare   Kaiser Family Foundation Medicare
​Employer sponsored insurance	Employees working 30+ hours per week	Coverage required for those working 30 hours or more Young adults can stay on plan until age 26 Same private insurance rules as below	Repeal tax credits for low-wage small employers, effective January 1, 2020. Requires that small business tax credits cannot be used to purchase plans that cover abortions, beyond Hyde limitations, effective in 2018	​Kaiser Family Foundation

References

• How Obamacare affects everyone