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The Bill to Replace Obamacare: Winners and Losers

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The Bill to Replace Obamacare: Winners and Losers

Erica Block

Updated: June 13, 2017    Published: May 4, 2017

The Bill to Replace Obamacare: Winners and Losers

If the American Health Care Act manages to successfully replace Obamacare, here are all the groups that will benefit and hurt the most.

The House voted on Thursday afternoon to approve the American Health Care Act (AHCA), a Republican-drafted measure that would eliminate many of the provisions of the Affordable Care Act. The bill’s passage, however narrow (the vote was 217-213), is nonetheless a victory for G.O.P. lawmakers who have vehemently opposed Obamacare. The bill will now move to the Senate, where it is expected to face a steep uphill battle.

Should the bill pass through the Senate, who will reap the benefits and who will shoulder the burden? Here are the winners and losers of the G.O.P. bill to replace Obamacare:

Who Wins?

High-income earners:

The American Health Care Act (AHCA), as the Obamacare repeal-and-replace bill is known, repeals two taxes targeting families and individuals who earn more than 250k per year. It also allows people to save more money in tax-excluded health savings accounts, a change that is only useful for people who have enough money to have savings.

Large businesses and employers:

The bill eliminates Obamacare’s employer mandate, which required large employers to offer affordable coverage to their workers. If the G.O.P bill becomes law, companies that do not wish to cover their employees will face no penalty.

Americans who wish to go without medical insurance:

They won’t have to pay a penalty for being uninsured.

Who Loses?


Nearly 400,000 low-income women will lose access to preventive health care due to the AHCA’s defunding Planned Parenthood. The bill includes stipulations to prevent Medicaid from reimbursing Planned Parenthood for preventive health services like contraception, Pap smears and sexually transmitted infection screenings.

People who are currently insured through Obamacare:

The bill will substantially reduce the funding for subsidies that the ACA provides to most people seeking health coverage through insurance marketplaces the law created.

LGBTQ community:

The G.O.P. bill allows States to eliminate the requirement for essential benefits coverage, such as mental health care and substance use treatment, and this would disproportionately impact members of the LGBTQ community.

Older Americans:

Under the new bill, insurers can charge senior citizens five times as much as they charge their youngest enrollees. Unsurprisingly, AARP opposed the GOP bill.

Children with special needs:

A provision of the bill cuts Medicaid benefits that help school districts cover the cost of special education services.

Public health programs:

The G.O.P. bill will eliminate funds for fundamental public health programs, including those that exist to prevent bioterrorism and disease outbreaks. It also cuts funding for immunizations and heart-disease screenings.


If the GOP bill passes in the Senate and eventually becomes a law, an estimated 24 million people will lose their health insurance in the next decade. Many of those people will have unexpected medical emergencies that require hospital care. Hospitals in poorer communities, where a lot of people are insured through Medicaid, will probably experience the biggest hit.

The views expressed here are those of the author and do not necessarily represent or reflect the views of Healthcare, Inc. and

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