ACA Compared to Repeal/Replace Efforts
7/7/2017

How do the American Health Care Act (AHCA), as passed by the House, and the Better Care Reconciliation Act (BCRA), as proffered in the Senate Discussion Draft, compare to the Affordable Care Act (ACA)?  The following chart compares and contrasts these Acts:

Provision

ACA

AHCA

BCRA

Cadillac Tax

·   40% excise tax on certain high-cost health plans eff. 2020

·    Tax delayed until 2026

·   Tax delayed until 2026

Employer Mandate

·   Penalty for not offering minimum essential coverage to all FTEs and their dependents

·   Penalty for not offering affordable coverage that provides minimum value to FTE who receives premium tax credit in Marketplace

·    Penalty reduced to $-0- eff. 1/1/16

·   Penalty reduced to $-0- eff. 1/1/16

Essential Health Benefits

·   Small group health plans must provide EHBs

·   All group health plans may not place annual or lifetime max on EHBs

·    States can apply for waiver from EHB requirements

·   States can obtain waiver from EHB requirements, cost-sharing limits, and actuarial value-level requirements

Form 1095 Reporting

·   Reporting required

·    No changes from ACA

·   No changes from ACA

HSA

·   Max contribution separate from/less than MOOP

·   20% penalty on non-qualified distributions

·    Max contribution tied to MOOP eff. 2018

·    Penalty reduced to 10% in 2017

·    Max contribution tied to MOOP eff. 2018

·   Penalty reduced to 10% in 2017

Individual Mandate

·   Penalty for no coverage

·    Penalty reduced to $-0- eff. 1/1/16

·    30% premium surcharge for coverage gap of more than 63 days eff. 2018

·   Penalty reduced to $-0- eff. 1/1/16

·   6-month wait for coverage gap of more than 63 days eff. 2019

Medical FSA

·   Statutory max on salary reduction

·    No statutory max eff. 2017

·   No statutory max eff. 2018

Medicare Part D – RDS

·   RDS expenses not deductible

·    RDS expenses deductible eff. 2017

·   RDS expenses deductible eff. 2017

Medicare Payroll Tax

·   0.9% tax for certain high-income individuals

·    Tax repealed eff. 2023

·   Tax repealed eff. 2023

OTC Medicine

·   Payable only with a prescription

·    Repealed eff. 2017

·   Repealed eff 2017

PCORI Fee

·   Plan sponsors owe annual fee through 2019

·    No changes from ACA

·   No changes from ACA

W-2 Reporting

·   Reporting of health coverage required

·    Reporting retained

·    Employers must indicate months an employee was eligible for coverage

·   No changes from ACA

If you have questions, call ASR Health Benefits at (616) 957-1751 or (800) 968-2449.