The following article by Valerie Peterson, J.D.  CEO of ElderCounsel is the most up-to-date status of President Trump’s repeal and replace efforts for the ACA:

On May 4, House Republicans passed the American Health Care Act (AHCA), an updated version of the Act first introduced in March and which was not voted on. If it passes in the Senate, it is likely to do so only after serious revision. As it stands now, should the AHCA pass, it would leave “24 million more people uninsured by 2026 than under Obamacare” (CNN)

There are several key changes made to the Affordable Care Act by the AHCA: it enacts per-capita caps (discussed in a post in early March), ends Medicaid expansion, ends three-month retroactive coverage, ends state’s option on home equity limits, and ends the Community First Choice financing boost. The AHCA also includes a 30% penalty for those who do not maintain continuous coverage, the new ability of insurers to charge older adults more for a plan, refundable tax credits now being based on age, and the ability for states to seek waivers for Essential Health Benefits – which could result in insurance companies charging more for persons with preexisting conditions.

Finally, the AHCA allows reduces the income threshold for Medical Expense Deduction, would consider over-the-counter drugs as qualified medical expenses, creates a 20% penalty for those who withdraw money from Health Savings Accounts for non-medical expenses, limits Flexible Spending Accounts, and repeals the Medicare Tax on high-income earners. The tax credits, ranging from $2,000 for those in their twenties to $4,000 in their sixties, have an income cap, beginning at $75,000; however, this legislation would also eliminate taxes imposed on the wealthy, insurers, prescription drug makers, and others (CNN).

What is this really about?

The biggest cuts in the AHCA have nothing to do with repealing and replacing Obamacare. The AHCA is attempting to completely overhaul the Medicaid program but cutting it by $880 billion dollars and leaving an additional 14 million without health care coverage. This is in spite of research showing that private insurers spend more for the same services a Medicaid enrollee receives.

Backlash against the cuts began in force shortly after passage of the bill.  AARP calls the cuts to Medicaid unsustainable.  Republicans struggle to explain the cuts to Medicaid.

Numerous health care organizations are against the AHCA as passed, including the American Medical Association, the American Academy of Family Physicians, The American Academy of Pediatrics, the American Nurses Association and the American Heart Association.

The Senate has now begun work on the bill, and it could take weeks, or possibly months before a vote is had on the AHCA. The Senate could either revise the current bill, or start from scratch with its own plan to repeal and replace the Affordable Care Act.