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Trumpcare (AHCA) Vs. Obamacare (ACA)

Trumpcare is a nickname for the American Health Care Act (AHCA), a replacement health insurance program for the Affordable Care Act (ACA or Obamacare) written by Republicans in the House of Representatives.

The American Health Care Act was voted on and passed in the House on May 4, 2017.

For the AHCA to become law, the U.S. Senate would have to vote on the bill and pass it with a majority vote. It would then require to go to the President’s desk, and he would have to sign it into law.

Q: How do the Affordable Care Act and AHCA (Trumpcare) treat individuals differently if they have a pre-existing condition? 

A: Both laws have regulations to prevent individuals from waiting until they get sick to purchase health insurance.

Trumpcare Vs. Obamacare Explained:

Under the Affordable Care Act (Obamacare), there is an individual mandate that requires every American to purchase a plan and maintain that coverage year-round. Those with a gap longer than two months usually have to pay a tax for being uninsured, and cannot enroll in new insurance until the next open enrollment period.

Under the AHCA, there is no individual mandate. Instead, states can apply for a waiver that would enable them to make their own rules that encourage persons to maintain health insurance coverage year-round.

Like the ACA, the AHCA sets up a system where an individual who stays insured, without an extended gap in coverage, will typically not pay a different price for health insurance based on whether or not that individual has a pre-existing condition.

Unlike the ACA, the AHCA gives states the authority to change the pricing rules for individuals who do not stay insured year-round.

One of the things a state can do is charge people who go uninsured for a long period, and have a pre-existing condition, a higher rate for their health insurance, for a specific time that is typically expected to be up to 12 months.

Q: Why not simply stick with the individual mandate to ensure everybody has health insurance?

A: The individual mandate has not worked.

• 19 million opt-out of Obamacare: According to a March 2017 article by the Associated Press, 19 million persons have opted-out of Obamacare, either by paying the uninsured tax (6.5 million) or by filing a hardship exemption (12.7 million).
• 18 million enroll in Obamacare –Approximately 18 million have enrolled, including about 11 million on government exchanges and almost another 7 million off exchanges.
• Most people who enroll in Obamacare  cancel their coverage – By some estimates, more than 20% of those who do enroll in Obamacare cancel their programs during the year. Some consumers who bought coverage on state-run exchanges have seen their plans canceled for unknown reasons.
• Most doctors don’t get paid by patients on Obamacare – According to the Great American Physician Survey, 45% of doctors with patients on Obamacare have challenges collecting large deductibles from patients, and 24% see claims denied because patients’ don’t pay their premiums.

Q: What is the Federal Invisible High Risk-Sharing Plan?

A: The Federal Invisible Risk Sharing Program is a pool of money set aside by the federal government to assist insurance companies in covering high medical cost individuals.

These risk pools vary from many risk pools used in the past because they’re invisible to the customer. In other words, high medical cost individuals usually would not know they’re in the risk pool.

Assuming they have maintained continuous coverage, such people are expected to pay the same price for their health insurance as healthy people.

Resources and References:

• How to Enroll in Obamacare
• Invisible Risk Sharing