Comparison of Medicare Provisions in Recent Bills and Proposals to Repeal and Replace the Affordable Care Act

Repealing and replacing the Affordable Care Act (ACA) is a top priority of the Trump Administration and the Republican leadership, and is a prominent issue on the agenda of the 115 th Congress. The ACA includes many provisions affecting the Medicare program, and lawmakers have taken different approaches to the ACA’s Medicare provisions. Some proposals would fully repeal the ACA, including all Medicare provisions. Other proposals, including the “American Health Care Act of 2017” (AHCA) as passed by the House of Representatives on May 4, 2017, would repeal some but not all Medicare provisions in the ACA.

This brief provides a side-by-side comparison of the Medicare-related provisions in seven bills and proposals that would repeal the ACA, excluding proposals that would not directly affect Medicare. Two of these proposals would repeal the ACA in its entirety, including all Medicare provisions. Three of the proposals, including the AHCA, would repeal some but not all Medicare provisions in the ACA, one proposal would retain all Medicare provisions in the ACA, and one does not specify. The first part of the side-by-side describes the Medicare provisions in the ACA that would be retained or repealed in each bill or proposal. The second part of the side-by-side describes the additional ways in which the bills and proposals would change Medicare, such as structural modifications to the Medicare program (e.g., premium support).

The bills and proposals in this comparison include:

Each of these bills and proposals make changes to the Medicare program that could have important implications for Medicare beneficiaries, the federal budget, health care providers, or private plans. This brief focuses on the key provisions in each of these bills and proposals that would directly affect Medicare, but is not a comprehensive summary of these bills and proposals.

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