AHCA: House Passed Version Mary Kate Mohlman, MS, PhD, Director of - - PowerPoint PPT Presentation

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Mar 13, 2023 222 likes •383 views

AHCA: House Passed Version Mary Kate Mohlman, MS, PhD, Director of Health Care Reform Adaline Strumolo, Health Care Director Georgia Maheras, Deputy Dir. of Health Care Reform 1 FOR DISCUSSION PURPOSES American Health Care Act

SLIDE 1

AHCA: House Passed Version

Mary Kate Mohlman, MS, PhD, Director of Health Care Reform Adaline Strumolo, Health Care Director Georgia Maheras, Deputy Dir. of Health Care Reform

1 FOR DISCUSSION PURPOSES

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American Health Care Act

Congressional bill that is to ‘repeal and replace’ the Affordable Care Act. Passed the House in May 2017. Senate is reviewing.

2 FOR DISCUSSION PURPOSES

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How would it impact Vermont?

Changes

– Private Insurance- Exchange impacts – Medicaid – Repeals Individual and Employer Mandates – Creation of Patient and State Stability Fund – Health Savings Accounts- additional funds – Reverses ACA financing provisions – Eliminates funding for planning and reproductive health services – Delays implementation of the “Cadillac Tax”

3 FOR DISCUSSION PURPOSES

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Vermont Insurance Coverage

Large Group, 216,400, 35% Small Group , 46,00 0, 7% Non-Subsidized Individual QHP, 12,000, 2% Subsidized Individual QHP, 22,000, 4% Medicaid, 150,500, 24% Medicare, 140,800, 22% Military, 14,400, 2% Federal , 14,400, 2% Uninsured, 13,100, 2% Large Group Small Group Non-Subsidized Individual QHP Subsidized Individual QHP Medicaid Medicare Military Federal Uninsured

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EXCHANGE IMPACTS

5 FOR DISCUSSION PURPOSES

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Private Insurance

Changes to tax credit structure and amounts

– Immediate changes to APTC – Repeals cost-sharing reductions – New age-based tax credit program in 2020

Continuous coverage requirement

– Replaces individual mandate – Surcharge for gaps in coverage

States can define Essential Health Benefits for purposes of the tax credit States can obtain waivers from certain market reforms

6 FOR DISCUSSION PURPOSES

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Based on 2017 data

How Federal Tax Credits Might Shift for Vermonters Based on Income and Age

-- Gross Annual Premium, Most Popular Silver Plan

For discussion purposes

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$95-$100M in income-based federal subsidies shifts to $80-$95M in potential age-based federal tax credits, spread out across a larger population.

Qualified Health Plan Population

For discussion purposes

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MEDICAID IMPACTS

9 FOR DISCUSSION PURPOSES

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Medicaid

Changes to enrollment, eligibility criteria and

documentation. Encourages more frequent

redeterminations. Medicaid Expansion: limits enhanced FMAP for expansion group to states that expanded prior to 3/1/17. Sunsets enhance FMAP rate on 1/1/20 except for individuals continuously enrolled after 12/31/19. Converts majority of Medicaid spending to Per Capita Funding starting in 2020.

– 2016 is baseline year.

Repeals Disproportionate Share Hospital (DSH) cuts.

10 FOR DISCUSSION PURPOSES

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ADDITIONAL RESOURCES

11 FOR DISCUSSION PURPOSES

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For additional information:

Tax credit comparisons: http://kff.org/interactive/tax-credits- under-the-affordable-care-act-vs-replacement-proposal- interactive-map/ ACA compared to AHCA (Kaiser): http://kff.org/interactive/proposals-to-replace-the-affordable- care-act/ ACA compared to AHCA (NASHP): http://nashp.org/what-the- american-health-care-act-means-for-states/ Health Affairs Blog: http://healthaffairs.org/blog/2017/05/04/house-passes-ahca- how-it-happened-what-it-would-do-and-its-uncertain-senate- future/

12 FOR DISCUSSION PURPOSES

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Family Income: $25,305 Total Cost for Health Care: $7,529.60 Current ACA Subsidy: -$4,534.40 AHCA Proposed Subsidy: -$2,000 Cost with Current ACA Subsidy: $2,995.20

Adult subsidized on VHC

Cost with AHCA Proposed Subsidy: $5,529.60

Median Income Individual-27 year old

For discussion purposes

SLIDE 14

Family Income: $37,144 Total Cost for Health Care: $15,787.20 Current ACA Subsidy: -$9,547.20 AHCA Proposed subsidy: -$6,000 Cost with ACA Subsidy: $6,240

Adults subsidized on VHC

Cost with AHCA Proposed Subsidy: $9,787.20

Median 2-person Household

For discussion purposes

SLIDE 15

Family Income: $51,020 Total Cost for Health Care: $14,060.80 Current ACA Subsidy: -$9,110.40 AHCA Proposed Subsidy: -$5,000 Cost with Current ACA Subsidy: $4,950.40

Adults subsidized on VHC
Children covered by Dr. Dynasaur

Cost with AHCA Proposed Subsidy: $9,060.80

Family of 4

For discussion purposes