Rep. Kelly Votes to Advance Obamacare Replacement Bill to Senate

May 4, 2017 Issues: Health Care

Bill includes strict protections for pre-existing conditions

“Repealing & replacing Obamacare is our unmistakable mandate”

WASHINGTON — U.S. Representative Mike Kelly (R-PA) – a member of the House Ways and Means Committee – issued the following statement today regarding the passage by the House of Representatives of the American Health Care Act (H.R. 1628), which will repeal and begin replacing the Affordable Care Act (Obamacare) with a more affordable, patient-centered system. Rep. Kelly also supported and co-sponsored corrective legislation (H.R. 2192) passed this afternoon to ensure that the American Health Care Act and its amendments apply equally to members of Congress and their staff.

“I have joined the People’s House in fulfilling a promise more than seven years in the making by voting to advance the American Health Care Act to the U.S. Senate. Repealing and replacing Obamacare has been our unmistakable mandate since it was first passed with blatant lies and deception, only to betray millions of Americans with higher costs, fewer choices, and lost coverage. Today marks the beginning of the end of this failed law’s broken promises and damage.

“The American Health Care Act represents the beginning of a better health care system that is patient-centered, choice-filled, and cost-lowering. With this bill, and future action taken by Congress and the Trump administration, American families and workers will be guaranteed access to affordable, high-quality health insurance in a competitive market based on freedom and flexibility. Taxes will be cut, premium-increasing regulations will be eliminated, and power will be rightly restored to individual states, patients, and their doctors. No more one-size-fits-all federal system.

“After exhaustive review, I have made sure that this bill fully protects patients with pre-existing conditions by strengthening current law and establishing new requirements for states to follow as they redesign their markets to meet their populations’ needs. I would not support this bill or any other bill if such strict protections were not included. Earlier this afternoon I also voted for a bill to guarantee that no member of Congress or our staff is exempted from the law or treated differently. As this process moves forward, my focus will continue to be on making sure health care policy defends the most vulnerable and promotes fairness for American consumers.”

NOTE: Read the full text of the American Health Care Act here.

The AHCA represents Phase One of the overall repeal and replacement of Obamacare. Phase Two includes administrative action taken by Health and Human Services Secretary Tom Price to adjust the marketplace to reduce health care costs. Phase Three includes other bills to increase the affordability and accessibility of health care insurance, including legislation recently introduced by Rep. Kelly.

The AHCA achieves the following:

·         Dismantles the Obamacare taxes that have hurt consumers and employers, increased premium costs, and limited options for patients and health care providers—including taxes on prescription drugs, over-the-counter medications, health-insurance premiums, and medical devices;

·         Eliminates the individual and employer mandate penalties, which forced millions of workers, families, and businesses into expensive Obamacare plans that they do not want and cannot afford;

·         Helps young adults access health insurance and stabilize the marketplace by allowing dependents to continue staying on their parents’ plan until they are 26;

·         Establishes a Patient and State Stability Fund and Federal Invisible Risk Sharing Program, which provides states with $130 billion to design programs that meet the unique needs of their patient populations, help low-income Americans afford health care, and provide a backstop safety net for Americans with pre-existing conditions. This includes $15 billion specifically toward mental health and substance abuse and newborn care;

·         Modernizes and strengthens Medicaid by transitioning to a “per capita allotment” so states can better serve their patients most in need. The Medicaid reform represents the largest entitlement reform in a generation and puts the program on a sustainable fiscal path;

·         Protects current Medicaid beneficiaries receiving health care under the expansion by honoring the enhanced state match they have been receiving, while working to redirect able-bodied adults to private health care so Medicaid can be refocused on helping the most vulnerable;

·         Empowers individuals and families to spend their health care dollars the way they want and need by enhancing and expanding Health Savings Accounts (HSAs)—nearly doubling the amount of money people can contribute and broadening how people can use it;

·         Helps Americans access affordable, quality health care by providing a monthly tax credit — between $2,000 and $14,000 a year — for low- and middle-income individuals and families who don’t receive insurance through work or a government program. Americans can use this tax credit to purchase private, quality coverage of their choice.

Details on Protections for Pre-Existing Conditions

The American Health Care Act (AHCA) explicitly protects individuals with pre-existing conditions. It upholds the current law which fully guarantees issuance of coverage, guarantees renewability of coverage, and prohibits insurance companies from denying patients coverage based on their condition.

The AHCA’s MacArthur amendment allows states to seek limited waivers to avoid some of the most expensive regulations in current law. This will give individual states more flexibility to innovate and redesign their own health care markets to reduce costs and give patients more choices. In order to be granted such a waiver, states must prove to the federal government that they are protecting individuals with pre-existing conditions by establishing a high-risk pool (funded by the AHCA’s Patient and State Stability Fund) or participating in the Federal Invisible Risk Sharing Program. If approved, a state can then operate the waiver for up to 10 years. At any point during an approved waiver, the waiver becomes void if a state ends its risk-sharing program.

In waiver-granted states, health insurers can only increase premiums for those with pre-existing conditions who buy their insurance on the individual market and then discontinue their coverage and do not obtain new insurance within 63 days. The risk-sharing program requirement is designed to stabilize premium costs for these specific individuals. (The 93 percent of Americans with employer-provided coverage or government coverage — including Medicare, Medicaid, Tricare, VA benefits, etc. — are in no way affected whatsoever.)

The AHCA’s Upton-Long amendment strengthens its protections for pre-existing condition patients by establishing a further relief mechanism for those described above. The amendment supplies waiver-granted states with an additional $8 billion (on top of the $130 billion available to states through the Patient and State Stability Fund) to reduce premiums or other out-of-pocket costs for this specific group of individuals.

Again, under the AHCA, even in waiver-granted states, insurance companies would be prohibited from denying coverage to individuals on the basis of a pre-existing condition, prohibited from rescinding coverage based on a pre-existing condition, and prohibited from raising premiums on individuals with pre-existing conditions who maintain continuous coverage. Each of these protections are current law and will remain the law.

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