2017: Schweikert Voted For The FY 2018 Republican Study Committee Budget Resolution Which In Part Called For Fully Repealing Obamacare And Replacing It With Parts Of AHCA. In October 2017, Schweikert voted for a budget resolution that would in part, according to Congressional Quarterly, "provide for $2.9 trillion in new budget authority in fiscal 2018. It would balance the budget by fiscal 2023 by reducing spending by $10.1 trillion over 10 years. It would cap total discretionary spending at $1.06 trillion for fiscal 2018 and would assume no separate Overseas Contingency Operations funding for fiscal 2018 or subsequent years and would incorporate funding related to war or terror into the base defense account. It would assume repeal of the 2010 health care overhaul and would convert Medicaid and the Children's Health Insurance Program into a single block grant program. It would require that off budget programs, such as Social Security, the U.S. Postal Service, and Fannie Mae and Freddie Mac, be included in the budget." The underlying legislation was an FY 2018 House GOP budget resolution. The House rejected the RSC budget by a vote of 139 to 281. [House Vote 555, 10/5/17; Congressional Quarterly, 10/5/17; Congressional Actions, H. Amdt. 455; Congressional Actions, H. Con. Res. 71]
2017: Schweikert Voted For The American Health Care Act That Which Would Result In 23 Million Fewer Americans With Health Insurance By 2026. In May 2017, Schweikert voted for the American Health Care Act which would have significantly repealed portions of the Affordable Care Act by cutting Medicaid, cutting taxes on the rich, removing safeguard for pre-existing conditions and defunding Planned Parenthood. The overall legislation would have in part, also according to Congressional Quarterly, "ma[d]e extensive changes to the 2010 health care overhaul law, by effectively repealing the individual and employer mandates as well as most of the taxes that finance the current system. It would [have], in 2020, convert[ed] Medicaid into a capped entitlement that would provide[d] fixed federal payments to states and end[ed] additional federal funding for the 2010 law's joint federal-state Medicaid expansion. It would prohibit federal funding to any entity, such as Planned Parenthood, that performs abortions and receives more than $350 million a year in Medicaid funds. [...] It would [have] allow[ed] states to receive waivers to exempt insurers from having to provide certain minimum benefits." The vote was on passage. The House passed the bill by a vote of 217 to 213. The bill, in modified forms, died in the Senate. [House Vote 256, 5/4/17; Congressional Quarterly, 5/4/17; Kaiser Family Foundation, 5/17; Congressional Actions, H.R. 1628]
Legislation Would Result In 14 Million Additional Uninsured Americans In 2018, Rising To 23 Million In 2026. According to the New York Times, "A bill to dismantle the Affordable Care Act that narrowly passed the House this month would leave 14 million more people uninsured next year than under President Barack Obama's health law --- and 23 million more in 2026, the Congressional Budget Office said Wednesday. Some of the nation's sickest would pay much more for health care. Under the House bill, the number of uninsured would be slightly lower, but deficits would be somewhat higher, than the budget office estimated before Republican leaders made a series of changes to win enough votes for passage. Beneath the headline-grabbing numbers, those legislative tweaks would bring huge changes to the American health care system." [New York Times, 5/24/17]
Legislation Would Cut Medicaid By $834 Billon Over The Next Ten Years, Including A Roll Back Of The Medicaid Expansion. According to the New York Times, "The House repeal bill was approved on May 4 by a vote of 217 to 213, with no support from Democrats. It would eliminate tax penalties for people who go without health insurance and roll back state-by-state expansions of Medicaid, which have provided coverage to millions of low-income people. And in place of government-subsidized insurance policies offered exclusively on the Affordable Care Act's marketplaces, the bill would offer tax credits of $2,000 to $4,000 a year, depending on age. [...] The bill would reduce projected spending on Medicaid, the program for low-income people, by $834 billion over 10 years, and 14 million fewer people would be covered by Medicaid in 2026 --- a reduction of about 17 percent from the enrollment expected under current law, the budget office said." [New York Times, 5/24/17]
Legislation Would Give States The Option Of A Per-Capita Cap On Medicaid Federal Funding Or A Block Grant; Overall Changes Would Result In 14 Million Fewer Medicaid Enrollees. According to NPR, Medicaid accounts for by far the biggest spending reductions under the American Health Care Act. The bill would roll back the Medicaid expansion instituted under the Affordable Care Act, which extended the program to cover some Americans with incomes up to 133 percent of the poverty line. That expansion increased enrollment by 10 million, as NPR's Alison Kodjak previously reported. Rolling back that expansion would limit future enrollments. The AHCA would also give states a choice: Receive Medicaid funding via either a block grant or a per capita amount per enrollee. Together, these changes would create major cuts in enrollment for the program: 14 million fewer people by 2026, and $834 billion in spending cuts over a decade." [NPR, 5/24/17]
Legislation Would Allow States To Seek A Waiver On Insurance Requirements. According to the Washington Post, "Congressional analysts concluded that one change to the House bill aimed at lowering premiums, by allowing states to opt out of some current insurance requirements, would encourage some employers to maintain coverage for their workers and get younger, healthier people to buy plans on their own. But those gains would be largely offset by consumers with preexisting conditions, who would face higher premiums than they do now." [Washington Post, 5/24/17]
About 1/6 OF Americans Would Live In States Receiving Insurance Waivers On Consumer Protections; These Markets Would Eventually Destabilize. According to the Los Angeles Times, "The House bill would be particularly harmful to older, sicker residents of states that waive key consumer protections in the current law, including the ban on insurers charging sick consumers more. The budget office estimates that about one-sixth of the U.S. population live in states that would seek such waivers, which would be allowed under the House bill. 'Over time, it would become more difficult for less healthy people (including people with preexisting medical conditions) in those states to purchase insurance,' the report notes." [Los Angeles Times, 5/24/17]
Premiums Would Drop In Some States, But Would Be Driven By Insurance With Fewer Benefits, Likely Driving Up Consumer Costs For Sicker Americans Such As Increased Costs For Pregnancy, Mental Health And Substance Abuse. According to the Los Angeles Times, "The budget office projected that average premiums for those who buy their own coverage would be lower in some states after 2020 than under Obamacare, an estimate quickly hailed by Republicans. [...] But the decrease would be driven largely driven by the fact that more people would have plans that cover fewer benefits and shift more costs to consumers, budget analysts wrote. Healthier consumers 'would be able to purchase nongroup insurance with relatively low premiums,' the budget office said. But skimpier plans with high deductibles would be particularly problematic for Americans facing high medical needs. 'Some people enrolled in nongroup insurance would experience substantial increases in what they would spend on healthcare,' the report notes. Out-of-pocket costs for pregnancy, mental health and substance abuse would likely 'increase by thousands of dollars' for people in some states, the budget office said." [Los Angeles Times, 5/24/17]
Americans Who Work At Large Firms Would Be At Risk For Receiving Insurance Without Essential Health Benefit Requirements. Acceding to the CBO, "For the large-group market, which generally consists of employers with more than 50 employees, current regulations allow employers to choose the EHB benchmark plan of any state in which they operate. Because of those regulations, a large employer operating in multiple states, including one that elected an EHB waiver, could base all of the plans it offers on the EHB requirements in a state with the waiver. That decision could allow annual and lifetime limits on benefits not included in the state's EHBs. However, large employers already have considerable flexibility in the range of the benefits they include in their plans, so CBO and JCT expect that their benefit offerings would probably not be noticeably affected by the actions of states." [CBO, 5/24/17]
A 64 Year Old American Earning $26,500 Annually Would See Their Annual Premium Increase From $1,700 To $13,600 In Waiver States. According to the Los Angeles Times, "Older and poorer Americans would also see higher premiums or lose coverage altogether. For example, under the House bill, a 64-year-old single American with an income of $26,500 a year would see his or her annual insurance bill jump from $1,700 to $13,600 in states that waive protections now mandated by Obamacare, according to the budget office. By contrast, a similar consumer who is 21 would see his or her premiums decrease from $1,700 to $1,250, budget analysts projected." [Los Angeles Times, 5/24/17]
CBO: States That Opt Out Of Community Rating Protections Would Lead To Sick Americans Being Priced Out Of The Insurance Market. According to the CBO, "Community-rated premiums would rise over time, and people who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive nongroup health insurance at premiums comparable to those under current law, if they could purchase it at all---despite the additional funding that would be available under H.R. 1628 to help reduce premiums. As a result, the nongroup markets in those states would become unstable for people with higher-than-average expected health care costs. That instability would cause some people who would have been insured in the nongroup market under current law to be uninsured." [CBO via Vox, 5/24/17]
The GOP Bill Repealed The 0.9% Medicare Hospital Insurance Surtax. According to the House Ways and Means Committee, "Obamacare imposed a Medicare Hospital Insurance (HI) surtax based on income at a rate equal to 0.9 percent of an employee's wages or a self-employed individual's self-employment income. This section repeals the additional 0.9 percent Medicare tax beginning in 2018." [House Ways and Means Committee, 3/6/17]
The GOP Bill Repealed The 3.8% Net Investment Tax. According to the House Ways and Means Committee, "Obamacare imposed a net investment tax, applying a rate of 3.8 percent to certain net investment income of individuals, estates, and trusts with income above certain amounts. This section repeals the net investment tax starting in 2018." [House Ways and Means Committee, 3/6/17]
Legislation Cut Taxes By $662 Billion, Mostly For The Wealthy. According to Vox, "The House bill would also cut taxes by $662 billion over the next decade, according to a separate analysis released Wednesday by the Joint Committee on Taxation, mostly by repealing Obamacare taxes on the wealthy and health care industries." [Vox, 5/24/17]
Legislation Would Reduce The Deficit By $119 Billion Over Ten Years. According to NPR, "The $119 billion deficit reduction represents a decline from previous versions. When the CBO first scored the AHCA, it said the plan would save $337 billion over 10 years. Later revisions reduced those savings to $150 billion. By far the biggest savings would come from Medicaid, which serves low-income Americans. That program would face $884 billion in cuts. Cutbacks in subsidies for individual health insurance would likewise help cut $276 billion. But those are offset in large part by bigger costs, including the repeal of many of Obamacare's taxes. Those tax cuts would overwhelmingly benefit the highest-income Americans, the Tax Policy Center, a Washington think tank, reported on Wednesday." [NPR, 5/24/17]
Legislation Repealed The Individual Mandate And Replaced Subsidies With Tax Credits Worth $2,000 To $4,000 For Health Insurance Based On Age. According to the New York Times, "The House repeal bill was approved on May 4 by a vote of 217 to 213, with no support from Democrats. It would eliminate tax penalties for people who go without health insurance and roll back state-by-state expansions of Medicaid, which have provided coverage to millions of low-income people. And in place of government-subsidized insurance policies offered exclusively on the Affordable Care Act's marketplaces, the bill would offer tax credits of $2,000 to $4,000 a year, depending on age. A family could receive up to $14,000 a year in credits. The credits would be reduced for individuals making more than $75,000 a year and families making more than $150,000." [New York Times, 5/24/17]
Legislation Replaced The Individual Mandate With A Potential 12 Month 30 Percent Premium Surcharge For Those Who Are Without Coverage For Longer Than 63 Days. According to Vox, "Unlike Obamacare, the AHCA does not mandate that all Americans be covered by health insurance or pay a fee. It repeals the individual mandate, which was one of Obamacare's least popular provisions. Instead, it has a different way of penalizing people who decide to remain uninsured: requiring those who don't maintain 'continuous coverage' to pay a hefty fine when they want to reenter the insurance market. This continuous coverage policy has shown up a lot in Republican replacement plans. It was part of Speaker Ryan's A Better Way proposal and Rep. Tom Price's Empowering Patients First Act. Here's how it works: If a worker goes straight from insurance at work to her own policy, her insurer has to charge her a standard rate --- it can't take the cost of her condition into account. But if said worker had a lapse in coverage longer than 63 days --- perhaps she couldn't afford a new plan between jobs --- and went to the individual market later, insurers could charge her a 30 percent premium surcharge. She would need to pay that higher premium for a full year before returning to the standard rate." [Vox, 5/4/17]
Legislation Would Allow Insurance Companies Charge Five Times, Instead Of Three Times, The Insurance Rate For Older Americans Compared To Younger Americans. According to CBO, "Relaxing the current-law requirement that prevents insurers from charging older people premiums that are more than three times larger than the premiums charged younger people in the nongroup and small-group markets. Unless a state sets a different limit, H.R. 1628 would allow insurers to charge older people five times more than younger ones beginning in 2018." [CBO, 5/24/17]
Legislation Would Prohibited Funding To Planned Parenthood. According to Congressional Quarterly, "It would, in 2020, convert Medicaid into a capped entitlement that would provide fixed federal payments to states and end additional federal funding for the 2010 law's joint federal-state Medicaid expansion. It would prohibit federal funding to any entity, such as Planned Parenthood, that performs abortions and receives more than $350 million a year in Medicaid funds." [Congressional Quarterly, 5/4/17]
Legislation Repealed Cost-Sharing Subsidies In 2020. According to the Kaiser Family Foundation, "ACA cost sharing subsidies are repealed effective January 1, 2020." [Kaiser Family Foundation, 5/17]
Legislation Repealed A Ten Percent Tax On Tanning Services. According to CNN, "The replacement health care plan proposed by Republicans would eliminate a 10% tax on indoor tanning services. The tax was introduced in 2010 as part of the Affordable Care Act. If the Republican plan becomes law, the tax will be phased out at the end of this year." [CNN, 3/7/17]
Legislation Repealed A Limitation On How Much Insurance Companies Can Deduct Executive Pay As A Business Expense. According to CNBC, "The proposed tax break, buried in cryptic language in the Republican plan, would allow health insurers to more fully deduct the value of their executives' compensation on their taxes. That compensation can be as high as tens of millions of dollars, in the case of CEOs of insurers. Those deductions currently are sharply limited by the Affordable Care Act, which caps at a maximum of $500,000 the amount of an individual executive's compensation that an insurer could deduct as a business expense. The cap applies to any executive, not just to CEOs." [CNBC, 3/8/17]
LA Times: The Legislation "Encourage[d] Health Insurance Companies To Pay Their Top Executives More." According to the Los Angeles Times, "Concealed within the 123 pages of legislative verbiage and dense boilerplate of the House Republican bill repealing the Affordable Care Act are not a few hard-to-find nuggets. Here's one crying out for exposure: The bill encourages health insurance companies to pay their top executives more. It does so by removing the ACA's limit on corporate tax deductions for executive pay." [Los Angeles Times, 3/7/17]
CBO Estimated That Repealing The Health Insurance Executive Tax Limitation Would Reduce Revenue By $500 Million Over Ten Years. [CBO, 5/24/17]
The House Voted On The Legislation Without Receiving An Updated CBO Score. According to The Hill, "House Republicans are once again fast-tracking consideration of their ObamaCare replacement bill without knowing the full impact of the legislation they'll vote on Thursday. The nonpartisan Congressional Budget Office (CBO) is not expected to have completed its analysis detailing the effects of the latest changes to the legislation overhauling the nation's healthcare system in time for the Thursday vote. Leadership's decision to press ahead with the floor action means lawmakers will be voting on the bill without updated figures from their nonpartisan scorekeeper on how many people would lose coverage under the bill or how much it would cost." [The Hill, 5/3/17]
2017: Schweikert Voted To Require Applicants To Provide A Social Security Number. In June 2017, Schweikert voted for legislation that would have, according to Congressional Quarterly, "amend[ed] both current law and the American Health Care Act (AHCA; HR 1628) passed by the House on May 4 to prohibit the advance payment of health care premium tax credits to individuals unless the Treasury receives confirmation from the Health and Human Services Department that the individuals' status as citizens or lawfully present aliens has been verified. The process to verify an individual's status must [have] include[d] the use of information related to citizenship or immigration status, such as Social Security numbers. The measure [would have made] verification of an individual's status mandatory for the current law's premium tax credit and, contingent on enactment of the AHCA, makes verification for the new tax credit under AHCA mandatory after 2017." The vote was on passage. The House passed the bill by a vote of 238 to 184. The Senate took no substantive action on the legislation. [House Vote 306, 6/13/17; Congressional Quarterly, 6/9/17; Congressional Actions, H.R. 2581]