House leadership and the Trump Administration are engaged in last-minute negotiations to secure passage of the American Health Care Act (H.R. 1628), a bill that would repeal significant portions of the Affordable Care Act. The bill would provide tax credits for the purchase of insurance and significantly reduce federal funding for Medicaid coverage. The smaller size of the credits relative to current subsidies for lower income families and individuals and Medicaid cuts led the Congressional Budget Office on March 13 to estimate that the number of uninsured Americans would increase by 14 million people in 2018, and by 24 million by 2026.
On March 22, the House Rules Committee approved a Manager's Amendment to the bill that would make changes intended to secure the votes necessary to pass the legislation, including an acceleration of the bill's $880 billion in tax cuts and allowing states to receive reduced Medicaid funding in the form of a block grant. The AMA sent a letter on March 22 urging members of the House of Representatives to vote "no" on the bill because of its negative impact on health insurance coverage and Medicaid funding. At press time, additional changes that include removing essential benefits requirements were under discussion.