The bill would change Affordable Care Act spending and revenue provisions. One major commercial health insurance market change would replace the current income-based ACA public exchange plan premium tax credit with an age-based tax credit. Other provisions would replace the ACA reinsurance, risk corridors and risk-adjustment programs with a new state health insurance market support grant program.
All Democrats who voted opposed the bill. Republicans voted for the bill 217 to 20.
Republicans hold just 52 votes in the Senate. Vice President Mike Pence, a Republican, could vote to break a tie.
H.R. 1628 supporters persuaded about 92% of House Republicans to vote for the bill today.
A budget measure needs 51 votes to pass in the Senate. That means that, if all Senate Democrats and independents oppose H.R. 1628, supporters must get the support of 96% of Senate Republicans to pass the bill.
Republicans' narrow majority in the Senate may make Susan Collins of Maine, Dean Heller of Nevada, and other moderate Senate Republicans key players in efforts to get the bill to President Donald Trump's desk.
Aetna Inc. may have given members of Congress an increased interest in the stability of the 2018 individual commercial health insurance market by announcing plans to pull out of Virginia's individual health market. Many members of Congress and congressional aides live in Washington suburbs in Virginia.
The version that passed in the House includes an amendment proposed by Rep. Tom MacArthur, R-N.J. That amendment would let states that apply for waivers put adults with health problems who have failed to keep continuous health coverage in force in special health coverage programs, or high-risk pools. States with waivers could also create their own local version of the ACA essential health benefits plans, or standard benefits packages.
The version also includes another, newer amendment that would provide $8 billion in subsidies over five years for financial assistance programs in states that set up the MacArthur waiver program risk pools, according to a summary of the current H.R. 1628 text posted on the House majority leader's floor action page.
Tom Price, the secretary of the U.S. Department of Health and Human Services, would be in charge of deciding how to allocate the $8 billion in MacArthur waiver program subsidy money.
A state could use its share of the subsidy money to help residents who face higher premiums as a result of the state's use of the waiver program.
--- Read Aetna to Quit Virginia's ACA Exchange as CEO Limits Risk on ThinkAdvisor.