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The Proposed American Health Care Act

by Pam Turos

June 27, 2017

After weeks of secrecy, the proposed American Health Care Act was unveiled earlier this week. There are significant changes and structures in the legislation that may have long-lasting implications for your family and community. The Senate has proposed an arbitrary deadline of July 4th for the Senate vote. Please note that the United States Senate will be in recess from July 1st – 9th and may be available to meet with their constituents to answer questions.

Contact Ohio Senators Brown and Portman:

Senator Sherrod Brown: Cleveland Office – (216) 522-7095 Washington D.C. Office -(202) 224-2315 Senator Rob Portman Cleveland Office – (216) 522-7095 Washington D.C. Office – (202) 224-3353 United Way has provided a glimpse into the most significant changes in the legislation.

  • Lowers the current ACA income-related premium tax credit to Americans earning 100%-400% FPL to 350% in 2020 vs. House age-based tax credit.

  • Medicaid: Restructures Medicaid funding using per-capita caps — a set amount of money per person — while giving states significant new flexibility for how they run their Medicaid programs, as funding burdens will be shifted to states. Gradually reduces federal funding for Medicaid (over 4-7 years), forcing states to cut services or coverage – most likely Medicaid expansion.

  • Allows states a waiver to opt out of major parts of ACA and create their own health care rules, such as waiving out of insurance requirements, including requiring states to have an exchange, rules for what benefits insurers must cover (maternity and mental healthcare), what qualifies as a health plan and the actuarial value of the plans.

  • Requires insurers to accept everyone and charge the same rates, with few exceptions.

  • Eliminates individual tax penalties for not having health insurance and penalties for employers not offering coverage for employees — predominantly benefitting people with high incomes and certain businesses.

  • Eliminates federal funding for Planned Parenthood.

  • Unclear if pre-existing condition protections will be maintained.

  • Does not include $45 billion fund to treat/prevent opioid addiction, which is being championed by Senators Portman and Capito.


  • In 2015, 52% of Ohio’s population – more than 5.9 million Ohioans – had private health insurance coverage through their employers.

  • About 26.6% — 4.2 million Ohioans – had public health insurance coverage through Medicaid, Medicare or other government programs.

  • 6% OF Ohioans were uninsured in 2015 and 5% (more than 600,000) had individual coverage, including 238,000 in Ohio’s federally run ACA individual marketplace.

  • The number of uninsured Ohioans decreased by half from 2013 to 2015, falling from about 1.4 million to 681,400 — largely due to the extension of Medicaid eligibility under the Affordable Care Act.

  • Beginning January 2, 2014, Medicaid coverage in Ohio was expanded to adults between ages 19 and 64 with income < 133% FPL and who weren’t eligible under other categories.

On a more personal note, regarding the Women’s Recovery Center clients, this legislation will have a significant impact in the unique Women’s Recovery center model of addiction treatment that currently integrates physical health with behavioral health. We are very proud to have a 54% treatment success rate, compared to a 34% average nationally. Treatment works.

The work we do has never been more important, in the wake of an opioid epidemic that has hit Ohio particularly hard. With proposed decreased access to addiction treatment, the death rate will continue to increase. The Center is currently seeing increased numbers of Hepatitis C infections and beginning to see increased volumes of new HIV infections related to the opioid crisis.

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