Rules Committee to adopt amendments Friday morning

House Speaker Paul Ryan (R-WI) notified House members Thursday, March 23 that they will vote Friday, March 24, on H.R. 1628, the American Health Care Act, which would repeal and replace the 2010 Affordable Care Act. The bill will be amended by the House Rules Committee, which will meet Friday morning at 7 a.m. to consider final changes to the bill. The Rules Committee is expected to adopt a second-degree amendment (attached) to the manager's amendment that was posted on the House Rules Committee web site on Monday (March 20).

These changes include:

— Removing the requirement that only the Secretary define Essential Health Benefits (EHB) as specified in the Affordable Care Act, and instead adding a new requirement that states define EHBs with respect to plans offered in their state beginning January 1, 2018 for purposes of the IRC Section 36B premium tax credit;

— Delaying the repeal of the .9% Medicare surcharge tax on individuals earning over $200,000 annually to taxable years after December 31, 2022; and

— Committing $15 billion in additional funding for states in flexibility grants to provide additional mental health, substance use, newborn and pregnancy services.

Also Thursday, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) released an estimate on the spending and revenue effects of H.R. 1628 (see attached PDF), incorporating the changes reflected in the March 20 manager's amendment as released by the Rules Committee. The estimate does not include the most recent round of proposed changes in the attached bill language.

The report states that " … enacting H.R. 1628 with the proposed amendments would reduce deficits by $150 billion over the 2017-2026 period … " The introduced version of the bill would have generated a $337 billion decrease in the deficit over 10 years. CBO stated that fewer people would lose Medicaid coverage under the manager's amendment compared with the Committee draft because of states' responses to faster growth in per capita allotments for aged, blind and disabled enrollees, but some of these effects would be offset by other changes in Medicaid.

The health insurance coverage estimates under the bill are similar to the previous version of the bill recommended by the House Energy & Commerce and Ways & Means Committees and differ by less than 500,000 in any category in any year over the next decade from the previous estimate. The manager's amendment did not significantly impact the CBO estimate of health insurance premiums compared with previous versions of the bill. These numbers could change when the EHB proposal is included in the estimate and also when the Senate incorporates changes to the bill (presuming House passage), including an expected inclusion of additional resources for health insurance tax credits for some populations including the 50-64 age group.

It is not clear if a revised CBO estimate of the final changes to the bill will be available prior to House floor consideration.

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ATTACHMENTS

CBO and JCT Report

Policy Amendment