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    AHCA next steps: 4 things MCOs should know


    3. The Senate might pass a revised bill.

    Nelson believes the Senate will likely pass a bill, but it will have substantial differences from the House bill. “Passage is a political necessity because Republicans will have ‘egg on their face’ for not making good on their promise to ‘repeal and replace’ the ACA after seven years, and also because Republicans share the overriding goals of delegating power to the states to set insurance rules and pass a tax reform bill later in the year,” he says.

    Fenton believes that the Senate could pass its own version of legislation. “But will House Republicans maintain their already razor-thin support for the AHCA once Senate changes are made?” he asks.

    4. If the Senate passes the bill and President Trump signs it into law, some provisions could be effective right away.

    Fenton says that some provisions of the House-passed AHCA would take effect immediately, and even retroactively in some cases (e.g., individual and employer mandates would be repealed as of January 1, 2016, and the annual fee on health insurers would be repealed effective January 1, 2017). Some provisions repealing certain ACA taxes and expanding health savings accounts would become law as soon as 2018, while other AHCA repeals and modifications (and potential state waivers) of certain market reforms would take effect beginning in 2020, and still other provisions would be delayed further (e.g., the Cadillac tax would not take effect until 2026, rather than 2020 as under current law).

    Karen Appold is a medical writer in Lehigh Valley, Pennsylvania.


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