On May 4, 2017, President Trump’s 105th day in office, the U.S. House of Representatives passed the American Health Care Act (“AHCA”) (H.R. 1628) by an incredibly slim margin. After the original bill to repeal and replace the Affordable Care Act failed to garner enough support in March, amendments were made to try to secure sufficient votes. The amendments give more leeway to the states to request waivers from certain provisions of the Act and provide additional funding to states to help reduce premiums for certain individuals with pre-existing conditions who may have difficulty obtaining affordable insurance in the Health Insurance Marketplace. The House passed the new bill by a vote of 217 to 213, with no Democrats voting to approve the bill.

If enacted into law, the AHCA will not repeal the ACA in its entirety, however, it will eliminate the “employer mandate” penalties and delay the “Cadillac” tax which imposes a 40% excise tax on employer-sponsored plans above a certain threshold. The employer mandate imposes a penalty on employers with 50 or more full-time and full-time equivalent employees (those working on average at least 30 hours of service per week in a given month) who fail to offer affordable, minimum value health coverage to full-time employees. If enacted, the AHCA will retroactively eliminate the employer mandate effective January 1, 2016. While this is certainly good news for Employers and a legislative triumph for Trump, enactment of the AHCA is far from guaranteed. Health policy experts say passing the Senate will be a considerable feat. For now, the fate of the ACA remains uncertain.