Ten Ways That the House American Health Care Act Could Affect Women
| Appendix 1: Comparison of Women’s Health Provisions in the ACA and House AHCA | |
| Affordable Care Act (ACA) | House American Health Care Act (AHCA) |
| Medicaid Policy | |
| Allow states to expand Medicaid eligibility to all adults up to 138% FPL. | Repeal enhanced federal match for Medicaid expansion except for those enrolled as of December 31, 2019 who do not have a break in eligibility of more than 1 month;
Convert federal Medicaid funding to a per capita allotment or block grant and limit growth beginning in 2020 using 2016 as a base year. |
| Planned Parenthood | |
| Planned Parenthood may receive federal reimbursements under Medicaid’s “any willing provider” provision. | Prohibit federal Medicaid funding for Planned Parenthood clinics for one year. |
| Abortion | |
| Prohibit abortion coverage from being required.
Federal premium and cost-sharing subsidies cannot pay for abortion beyond Hyde limitations. Prohibit plans from discriminating against a provider because of unwillingness to provide, pay for, cover, or refer for abortions. |
Prohibit all qualified health plans from covering abortion beyond Hyde limitations.
Prohibit federal premium tax credits from being applied to premiums of non-Marketplace plans that cover abortion services beyond Hyde limitations. Ban small employers from receiving tax credits if their plans include abortion coverage beyond Hyde limitations. |
| Subsidies | |
| Premium tax credits based on age, income and location to eligible individuals with incomes between 100-400% FPL on a sliding scale.
Provide cost-sharing subsidies to eligible individuals with household income between 100%-250% FPL. |
Replace ACA income-based tax credits with flat tax credit adjusted for age only.
Repeals cost-sharing subsides as of January 1, 2020. |
| Preexisting conditions | |
| Prohibit pre-existing conditions exclusions, which historically have included pregnancy, prior C-section, and mental illnesses, and rate surcharges based on health status. | Retain ban on pre-existing conditions exclusions. Those with coverage gaps could be charged 30% more for premiums for the first year of resuming coverage or state could request a waiver to permit insurers to medically underwrite for one year, charging sicker individuals higher rates for that year. |
| Gender Rating | |
| Ban discriminatory premium pricing based on gender in all group and individual insurance plans. | Ban on gender rating is not changed. |
| Essential Health Benefits (EHB) | |
| Require all private insurance plans to cover 10 EHB categories, including maternity care and mental health services. | EHB standards are repealed for the Medicaid expansion population.
States could apply for a waiver to re-define EHBs for the individual and small group health insurance markets. |
| Preventive Care | |
| Require almost all private plans to cover preventive care without cost-sharing, including contraception and breast cancer screenings. | Requirement for individual and group plans to cover preventive benefits, without cost sharing is not changed. |