On May 4 House Republicans passed a revised version of the American Healthcare Act under a narrow, 217-213 party line vote. The revised bill, which was voted on before it could be scored by the Congressional Budget Office, now moves to the Senate, where it is expected to undergo major changes.

The revised bill keeps most of the core tenets of the previously failed AHCA. A number of those directly affect people with disabilities, including: replacing income based subsidies with fixed tax-credits based on age, distributing federal Medicaid funding based on a per-capita rather than cost-based system, and no longer requiring Medicaid to provide a minimum of “essential health benefits.” For a summary of the how the base provisions of the AHCA affect people with disabilities, please see our previous coverage here.

Under current law, insurers are required to accept people with pre-existing conditions without charging them higher premiums. Under a revision to the AHCA, states would be able to obtain a waiver to this requirement. In turn, they would be required to setup “high-risk pools” for those with pre-existing conditions. Insurers would have no upper limit on the amount they charge those in high-risk pools for premiums. A last minute amendment added $8 billion dollars in funding to the Patient and State Stability Fund, which is partly aimed to defray costs within the high-risk pools, but as The Atlantic noted in its analysis of the policy revision, this “is likely a drop in the bucket.”

Revisions would also allow states to define what “essential health benefits” insurance plans are required to cover. States could allow insurers to offer bare bones coverage policies to help keep costs down, which could in turn affect employer plans that use individual plans as benchmarks for the coverage they provide.

Medical organizations voiced strong opposition to the passage of the AHCA, with the American Medical Association and the AARP issuing statements denouncing the bill soon after it was passed. United Spinal Association issued a news release on May 8 condemning the AHCA, arguing that the revisions would allow states to cut people with disabilities from the general insurance marketplace.

“The AHCA will hurt people with disabilities through higher health care costs, less coverage, and a greater risk of institutionalization,” said James Weisman, the president and CEO of United Spinal. “Critical services such as personal care, mental health treatment, prescription drugs and rehabilitation services should also not be cut to save money.” Visit United Spinal’s Trumpcare Needs to be Stopped action page for more information, including how you can advocate for better health care.

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