Comparison of Medicare Provisions in Recent Bills and Proposals to Repeal and Replace the Affordable Care Act

Repealing and replacing the Affordable Care Act (ACA) is a top priority of the Trump Administration and the Republican leadership, and is a prominent issue on the agenda of the 115th Congress. The ACA includes many provisions affecting the Medicare program, and lawmakers have taken different approaches to the ACA’s Medicare provisions. Some proposals would fully repeal the ACA, including all Medicare provisions. Other proposals, including the “American Health Care Act of 2017” (AHCA) as passed by the House of Representatives on May 4, 2017, would repeal some but not all Medicare provisions in the ACA.

This brief provides a side-by-side comparison of the Medicare-related provisions in seven bills and proposals that would repeal the ACA, excluding proposals that would not directly affect Medicare. Two of these proposals would repeal the ACA in its entirety, including all Medicare provisions. Three of the proposals, including the AHCA, would repeal some but not all Medicare provisions in the ACA, one proposal would retain all Medicare provisions in the ACA, and one does not specify. The first part of the side-by-side describes the Medicare provisions in the ACA that would be retained or repealed in each bill or proposal. The second part of the side-by-side describes the additional ways in which the bills and proposals would change Medicare, such as structural modifications to the Medicare program (e.g., premium support).

The bills and proposals in this comparison include:

  • “American Health Care Act of 2017,” H.R. 1628, introduced on March 20, 2017 by Rep. Black (R-TN) as chairperson of the House Budget Committee and passed by the House on May 4, 2017.
  • “American Health Care Reform Act of 2017,” H.R. 277, introduced by Rep. Roe (R-TN), on behalf of the Republican Study Committee, in January 2017.
  • “A Better Way,” released by Speaker Ryan (R-WI) in June 2016.
  • “World’s Greatest Healthcare Plan Act of 2016,” H.R. 5284 and S. 2985, introduced by Rep. Sessions (R-TX) and Sen. Cassidy (R-LA) in May 2016.
  • “A Balanced Budget for a Stronger America,” FY2017 Budget Resolution, released by the House Budget Committee, chaired by former Rep. Price (R-GA) (now HHS Secretary), in March 2016.
  • “Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015,” H.R. 3762, introduced by former Rep. Price (R-GA) (now HHS Secretary), passed by the House and Senate, and vetoed by the President in February 2016.
  • “Empowering Patients First Act of 2015,” H.R. 2300, introduced by former Rep. Price (R-GA) (now HHS Secretary) in May 2015.

Each of these bills and proposals make changes to the Medicare program that could have important implications for Medicare beneficiaries, the federal budget, health care providers, or private plans. This brief focuses on the key provisions in each of these bills and proposals that would directly affect Medicare, but is not a comprehensive summary of these bills and proposals.


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