The agreement, brokered by the House Freedom Caucus chairman and Tuesday Group co-chairman Tom MacArthur (R-NJ), would allow states to eliminate Obamacare’s community rating system — a rule that prohibits health insurers from pricing health care plans based on age, gender, or health status. States that repeal Obamacare’s community rating rules would have to join a high-risk pool to obtain the waiver.Not only have we made good progress, we have to get give a good shout out to Tom MacArthur and the President and the Vice President for their efforts in the last couple of weeks. It would be a mistake to suggest that had Tom MacArthur, the President, and the Vice President have not gotten involved in this process, then we would not have the options now for everyone to consider. Tom has worked closely hard with Energy and Commerce Chairman Greg Walden and the committee to make sure that what we do is keeping in line with repealing and replacing Obamacare and drives down premiums and keeps pre-existing conditions.
The deal, known as the MacArthur amendment, would also reinstate Obamacare’s Essential Health Benefits, although states could waive these if they were to prove that eliminating those regulations would lower premiums, increase the number of people insured, or “advance another benefit to the public interest in the state.”
Essential Health Benefits require that health insurance plans must cover certain services such as doctors’ services, inpatient or outpatient hospital care, prescription drugs, pregnancy, childbirth, and mental health.
The American Health Care Act replaces a number of Obamacare’s taxes and subsidies with age-based tax credits to help people buy health insurance on the individual market. Freedom Caucus members, including Congressman Jim Jordan, previously said that the tax credits would create a new entitlement program. The AHCA repeals Obamacare’s employer mandate, while it replaces the individual mandate with a 30 percent insurance premium surcharge for those who forgo health insurance. The bill will also cap Medicaid per capita starting in 2020.