Health care reform

Changes to the AHCA before House vote

House Republicans are making some changes to the AHCA. Here’s what you need to know.


Republicans from the U.S. House of Representatives are making some changes to the American Health Care Act (AHCA) before a floor vote, which may happen on Thursday, March 23.

Here is a quick rundown of the changes:

The biggest changes the House GOP is making:

  • Immediately prohibiting additional states from expanding Medicaid. It would also “freeze” Medicaid enrollment at ACA levels on Dec. 31, 2019, meaning states would not get money to cover new enrollees at Obamacare payment rates.
  • Giving states the option of establishing a work requirement for able-bodied Medicaid recipients or choosing a lump sum payment instead of payments based on the number of enrollees.
  • There will be a more generous Medicaid inflation adjustment for the costs of elderly and disabled patients.
  • Repeal of all of the Affordable Care Act (ACA) taxes in 2017 instead of 2018, and moving the repeal of the health law’s Cadillac tax from 2025 to 2026.
  • Setting up a fund to establish additional tax help for Baby Boomers age 50 to 64 who would have seen their premiums spike under the original bill.

What the House GOP left out:

  • It doesn’t end the Medicaid expansion earlier, as conservatives wanted.
  • It doesn’t try to repeal the ACA’s insurance regulations. That can’t be done in a budget reconciliation bill.

It is rare for legislation to reach the floor unless leadership is certain they have the votes for passage. Speaker Paul Ryan intends to hold the floor vote on the AHCA this Thursday, March 23, and it is unclear if he has the 216 votes necessary for passage. Why vote this Thursday? March 23 is the 7-year anniversary of President Barack Obama signing the Affordable Care Act into law.

While four on-the-fence Republicans officially threw their support behind the revised bill, the changes may not be good enough for the conservative Freedom Caucus.

Freedom Caucus Chairman Mark Meadows said “our leadership is going to put forth a bill that does not address any of the concerns in a meaningful way and will dare us to vote against it.” He says the group won’t take a formal position against it, so that frees up some group members to vote for it.

Rep. Justin Amash tweeted: “They haven’t changed the bill’s general framework. They don’t have the votes to pass it. They have seriously miscalculated.”

Despite these changes, the AOA still does not support the AHCA. Now is the time to tell Congress that the AHCA should be rejected because it reduces coverage and patient access to care. Take action today!

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