May 4th marks the one-year anniversary of the U.S. House of Representatives passing the American Health Care Act (AHCA), a bill that would have put millions of Americans at risk of losing affordable health care. The bill would have ended Medicaid as we know it, eliminated the insurance protections of the Affordable Care Act (ACA), raised premiums on older adults, and undermined Medicare. While AHCA ultimately failed to become law, efforts to unravel the ACA have continued.
Late last year, Congress passed a tax bill that included a provision eliminating the ACA’s individual mandate, which was widely seen as the linchpin for the ACA’s individual market. In addition, the Administration has taken several steps to reduce spending to support the ACA, including stopping cost-sharing reduction (CSR) payments that helped reduce premiums for consumers, ending most marketing and advertising for ACA markets, and changing ACA enrollment rules to make plans harder to buy and keep.
We are starting to see the impact of these changes. This week, the Commonwealth Fund’s Affordable Care Act Tracking Survey showed recent coverage declines among 19-to-64-year-olds. The survey’s focus is on adults who gained coverage through the ACA’s marketplaces and Medicaid.