March 21, 2017

The American Health Care Act vs. The Better Care Reconciliation Act vs. The Affordable Care Act: A Side-by-Side Comparison

Note: This update was revised on July 14 to reflect the Senate's draft of ACA "repeal-replace" legislation.

In a close vote of 217-213, the U.S. House of Representatives passed the American Health Care Act (AHCA) on May 4, 2017. Eight weeks later, the Senate GOP leadership released a discussion draft titled the Better Care Reconciliation Act of 2017 (BCRA). It’s important for health care stakeholders to get educated on the substantial changes these two legislative proposals would bring, and how these changes compare to both existing law under the Affordable Care Act (ACA). To assist in this process, we have created a resource providing a comparative analysis of the AHCA, BCRA and the ACA that highlights each bill’s treatment of a number of core issues, including insurance subsidies, individual and employer mandates, essential health benefits and Medicaid expansion. We will continue to update this chart to reflect substantial changes made as GOP leadership readies the BCRA for a Senate vote.

The chart evaluates the following key issues:

  • Insurance subsidies
  • Individual mandate
  • Employer mandate
  • Young adults
  • Essential health benefits
  • Prohibitions on annual and lifetime limits
  • Age-rated limit
  • Health status premium underwriting
  • Preexisting condition coverage
  • Relief for high risk individuals
  • Medicaid expansion
  • Traditional Medicaid
  • Health Savings Accounts (HSAs)
  • Tax provisions

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