Select Affordable Care Act replacement plans and implications

February 1, 2017

White paper reading "ACA Affordable Care Act" with a stethoscope and pen laid over it.No single replacement for the Affordable Care Act (ACA) has yet emerged. However, there are several ideas that seem to have considerable support among those in health care leadership roles in President Trump’s Administration and Congress.

This brief, Select Affordable Care Act Replacement Plans and Implications, summarizes the key features of the most developed full repeal and replacement plans offered to date.

The provisions that are summarized include:

  • Replace the individual mandate with a continuous coverage requirement
  • Change tax subsidies
  • Expand Health Savings Accounts (HSAs)
  • Allow adult dependents up to age 26 to stay on their parents’ plan
  • Replace the ACA’s “Cadillac Tax” with a cap on the tax exclusion for employer-sponsored insurance
  • Medicaid block grants per capita cost limits
  • Implement high-risk pools
  • Loosen benefit design requirements
  • Widen age bands
  • Permit association health plans
  • Permit interstate insurance sales
  • Reform medical liability

The brief summarizes Representative Paul Ryan’s A Better Way proposal, Representative Tom Price’s Empower Patients First Act, and Senator Richard Burr, Senator Orrin Hatch, and Representative Fred Upton’s The Patient Choice, Affordability, Responsibility, and Empowerment Act. It also details who is primarily affected by each provision and the implications.

You can also see CHRT’s companion piece, ACA Repeal and Replacement: Proposals and Action, for a one-page summary of the plans and tentative process.