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The Senate failed to pass the AHCA, which means it cannot become a law. The following information provides an outline of the AHCA, which failed to become law.
In 2017, the US House of Representatives introduced a proposed bill called the American Healthcare Act of 2017 or AHCA. This bill, also known as Trumpcare, would serve to amend and even partially repeal part of the Affordable Care Act (ACA).
The AHCA did not become law as it did not pass in the Senate. Still, the bill helped to provide a better understanding of many of the things that go into healthcare insurance plans and how they work. A look at some of the provisions of the AHCA also helps to shine a light on many of the aspects of the ACA, or Obamacare, which is still in effect.
Below, we explain Trumpcare vs Obamacare by highlighting the similarities and differences of the two programs.
What is Obamacare?
Obamacare is the nickname for the Affordable Care Act (ACA), which was signed into law by President Barack Obama in 2010. The act brought significant changes to the U.S. healthcare system by reducing the amount paid by individuals and families for uncompensated care. Obamacare mandated that everyone had a healthcare plan unless they qualified for hardship or another type of exemption.
Obamacare prohibits insurance companies from denying a person coverage or charging more for a plan if that person has a pre-existing condition. The act requires insurance companies to cover certain basic services, such as preventative care and prescription medications. It also provides subsidies for low income families to ensure they could afford their healthcare coverage.
Does Obamacare still exist?
Despite many votes on whether or not to repeal it, the ACA still exists and is still the law of the land for healthcare coverage. The ACA has gone through some small changes and modifications since its inception. The largest change was the elimination of the individual mandate penalty that required individuals without health insurance coverage to pay a fee.
Despite any changes, the ACA is still immensely popular and is used by individuals in every part of the country. In fact, as of early 2022, approximately 35 million people have enrolled in ACA-supported healthcare coverage. These record numbers are only part of the large impact the ACA continues to have on healthcare insurance, Medicaid, and Medicare coverage.
What is Trumpcare?
So now that we’ve covered Obamacare, what’s the definition of Trumpcare? Trumpcare is the nickname for the American Health Care Act (AHCA). This plan was written by Republicans in the House of Representatives as a replacement plan for the ACA. The AHCA was voted on and passed in the House on May 4, 2017.
While the AHCA never passed through the Senate and became law, President Trump did sign an executive order in 2020 declaring it U.S. policy to protect people with pre-existing health conditions. This policy was already in place through the current ACA, but other specifics of Trumpcare differ from Obamacare.
Does Trumpcare currently exist?
Trumpcare was only a proposal and went no further. The Senate never approved the proposal, and so Trumpcare never became law. Some politicians created a few additional proposals to rival Obamacare that also failed or never received a vote, such as the Better Care Reconciliation Act (BCRA), Obamacare Repeal Reconciliation Act (ORRA), and the Healthcare Freedom Act (HCFA).
What is the difference between Obamacare and Trumpcare?
What is the difference between Obamacare and Trumpcare? Here is Trumpcare vs Obamacare explained in more detail.
Trumpcare sought to eliminate a lot of the federal spending that came with Obamacare. In addition, the Trumpcare bill was strongly against the individual and employer mandates associated with Obamacare. These things formed the key differences between the ACA and the proposed AHCA.
Trumpcare would remove the tax penalty for failing to enroll in healthcare and it would remove some of the requirements the ACA placed on healthcare insurers to provide specific types of care. In addition, Trumpcare sought to give control of Medicaid management to the states. The below comparison shows where the two bills differed on key policy points.
Refer to the chart below for a side-by-side comparison of the two healthcare plans.
Trumpcare vs. Obamacare explained:
| Key Policy Differences | Obamacare (ACA) | Trumpcare (AHCA) |
| Federal tax penalty for failing to enroll in an insurance plan | Yes | No |
| Subsidies to help low income individuals afford insurance | Yes | Yes |
| Plans required to offer benefits such as preventative care | Yes | No, if state receives a waiver from the federal government |
| Adult children can remain on parent’s plan until age 26 | Yes | Yes |
| Designated open enrollment periods to purchase a plan | Yes | Yes |
| Special enrollment periods based on some life events | Yes | Yes |
| Government agency that determines mandatory benefits | Federal agencies | Federal agencies or states that are granted a waiver |
| Caps on profit-taking through medical loss ratio rules | Yes | Yes |
| State authority to manage Medicaid | No | Yes |
| Federal Invisible Risk Sharing Program | No | Yes |
What is the Federal Invisible Risk Sharing Program?
The Federal Invisible Risk Sharing Program is a pool of money set aside by the federal government to help insurance companies cover high medical cost individuals. These risk pools differ from many risk pools used in the past because they are invisible to the customer. In other words, high medical cost individuals typically would not know they are in the risk pool. Assuming they have maintained continuous coverage, high-risk individuals are expected to pay the same price for their health insurance as people who are healthy.
Obamacare vs. the House of Representatives plan vs. the Senate plan
In addition to the differences between Obamacare and Trumpcare, there are also key variations between the plans introduced by the House of Representatives vs. the Senate:
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