House Republican leaders posted a new packet of American Health Care Act bill materials on their website late Wednesday, and they say they could bring AHCA up for a new vote on the House floor by the end of the week.
House members could consider the same version of AHCA, H.R. 1628, that came close to getting a floor vote in March, along with two major proposed amendments.
(Read Stalled Health Bill Wins New Support From Conservative Holdouts on ThinkAdvisor.)
The underlying AHCA bill would make many changes to Affordable Care Act funding and spending provisions. To strongly discourage people from waiting until they get sick to pay for coverage, the bill would create a new late-enrollment penalty for health coverage buyers who fail to keep major medical coverage in place after they become adults.
One of the amendments heading toward the House floor is the widely discussed ACA rule waiver amendment proposed by Rep. Tom MacArthur, R-N.J.
The proposed MacArthur amendment would let a state bring back some medical underwriting if the state set up a special insurance program, or “high-risk pool,” for people with health problems, or if the state agreed to participate in a new federal “invisible risk pool” program, according to the amendment text included in the packet. The invisible risk pool program would be somewhat like a new version of the temporary ACA reinsurance program, which expired at the end of 2016.
Summaries of the proposed MacArthur amendment released in the past week have not been clear about how the medical underwriting provision would work. The amendment would let states allow medical underwriting only for health coverage buyers who had failed to keep health coverage in place.
In a state with a risk pool that received a MacArthur amendment ACA rule waiver, a health insurer could ask a consumer to pay more for coverage if the consumer had not kept health coverage in place. The insurer could not deny the consumer access to coverage.
A state with a MacArthur ACA rule waiver could also adopt its own version of the ACA essential health benefits package, or standard benefits package.
The MacArthur amendment does not appear to set any minimum federal standards for the MacArthur-waiver state risk pools, the MacArthur-waiver invisible risk pool program or the MacArthur-waiver state essential health benefits packages.