House Republicans Just Passed Their Replacement For Obamacare. Here's What You Need to Know

The conservative pursuit to completely wipeout and replace Obamacare could be nearing its end. The House of Representatives voted Thursday 217-213 to pass a new version of the troubled Republican health care bill, which was pulled in March due to its likelihood to fail. The bill is not law yet—the Senate still has to vote on it.

But if the bill does manage to pass, here's what you can expect in the future.

Fewer Insured Americans

The nonpartisan Congressional Budget Office estimated that the new health care law would result in up to 24 million more uninsured people in the U.S. by 2026, according to ABC News.

Tax Cuts

The New York Times reports that the new bill would cut the taxes of high-income people by about $300 billion over the next decade. The House bill rolls back the payroll and investment income taxes imposed by the Affordable Care Act, which helped pay for the expansion of Medicaid.

Medicaid Will Be Cut

To replace the savings on tax cuts, Medicaid would be cut down by $880 billion over 10 years. This would end the open-ended entitlement Medicaid enjoys right now, replacing it with a budgeted yearly allotment or federal grant. According to NBC News, more than 14 million people could drop off Medicaid after a decade due to these substantial cuts. Medicaid also provides money for programs like education for special needs children.

States Can Opt Out Of Making Insurers Cover Essential Health Benefits & Pre-Existing Conditions

One of the most controversial points of the House health care bill was the state waiver amendment, otherwise known as the MacArthur amendment. Representative Tom MacArthur of New Jersey negotiated this requirement to appease the very conservative House Freedom Caucus.

The amendment states that states can seek a waiver to opt out of mandating that its insurers cover essential health benefits in all of its plans, including prescriptions, maternity care and mental health care. This means that if someone can only afford the lowest-tier insurance coverage, some of their most basic medical needs still would not be covered.

In addition, states could obtain waivers to opt insurers out of non-discriminatory practices when it comes to people with pre-existing conditions. Insurance companies currently cannot charge someone with a pre-existing condition more than they’d charge a healthy person of the same age. The MacArthur amendment transforms pre-existing conditions into extreme financial burdens—and pre-existing conditions can include things like being treated for rape or domestic violence, along with more obvious conditions like cancer or congenital disorders.

Jimmy Kimmel gave an emotional speech about this issue Monday night, which quickly went viral. He talked about the health scare his family faced when his son was born with a heart defect, which required immediate open-heart surgery. Without guarantees for people with pre-existing conditions, saving his son’s life would turn into an issue of affording care.  

People With Pre-Existing Conditions Will Depend On High-Risk Pools

The MacArthur Amendment that brought the most conservative House Republicans onboard with the House bill is also a major reason why the more moderate Republicans did not support the health care act.

This is why Rep. Fred Upton of Michigan came up with the Upton Amendment, which provides $8 billion over five years to offset high insurance premiums for people with pre-existing conditions. According to NBC News, this money would supplement the $130 billion proposed to temporarily fund high-risk pools in states that obtain waivers. High-risk pools are used to try to offset extremely high medical costs and insurance premiums for people with serious medical conditions.

However, many experts don’t think the Upton Amendment does enough to offset the implications of the waiver program.

“Even with all the layers of funding in the bill and the subsequent amendments, the money falls short of what would really be necessary to cover the cost of people with pre-existing conditions,” said Larry Levitt, Senior Vice President at the Kaiser Family Foundation, to NBC News.

Tax Credits Replace Individual Help

Under Obamacare, Americans would receive individual subsidies to help pay for insurance if work or government programs did not already provide it. The new bill instead offers anywhere between $2,000 to $4,000 in tax credits per person, and up to $14,000 per family, each year.

However, the individual mandate will also be cut by the new health care bill. This means uninsured Americans will no longer face tax penalties for not purchasing insurance.

Insured Americans, however, may face up to a 30 percent surcharge if they let coverage lapse for more than 63 days within a year, according to Fox News.

Older Americans Would Face Higher Premiums

Currently, under federal law, older adults cannot be charged more than three times what insurance companies charge young adults. According to the Times, the new bill would allow insurers to charge older Americans up to five times more than young Americans.

Young Americans, however, can still remain on their parent’s insurance until age 26.

Now that the bill has officially passed the House, one of Donald Trump’s main campaign promises is nearly fulfilled. In the near future, you can probably expect the always over-confident Trump administration to roll back Affordable Care Act measures aggressively to make way for the Republican health care bill.

The measure still must pass the Senate, which won’t be exactly easy—Republicans have an even smaller majority there. The bill cannot afford to lose even three votes, or else it fails.