Trumpcare is a nickname for the American Health Care Act (AHCA), a replacement plan for the Affordable Care Act (ACA or Obamacare) that was written by Republicans in the House of Representatives.

The AHCA was voted on, and passed in the House on May 4, 2017.

Here’s a breakdown on how the two pieces of legislation match up.

Q: How do the ACA (Obamacare) and AHCA (Trumpcare) treat people differently if they have a pre-existing condition? 

A: Both laws have rules in place to prevent people from waiting until they get sick to buy health insurance.

Here is how they differ:

Under the ACA (Obamacare) there is an individual mandate, which requires every American to buy health insurance and maintain that coverage year-round. Those with a gap longer than two months generally have to pay a tax for being uninsured, and can’t sign up for new insurance until the next open enrollment period.

Under the AHCA (Trumpcare) there is no individual mandate. Instead, states can apply for a waiver that would allow them to make their own rules that encourage people to maintain health insurance coverage year-round.

Like the ACA, the AHCA sets up a system where a person who stays insured, without an extended gap in coverage, will typically not pay a different price for health insurance based on whether or not that person has a pre-existing condition.

But, unlike the ACA, the AHCA give states the authority to change the pricing rules for people who do not stay insured year-round.

One of the things a state can do is charge people who go uninsured for an extended period of time, and have a pre-existing condition, a higher rate for their health insurance, for a certain time period that is generally expected to be up to 12 months.

Q: Why not simply stick with the individual mandate to make sure everyone has health insurance?

A: The individual mandate has not worked.

• 19 million opt-out of Obamacare: According to a March 2017 article by the Associated Press, 19 million people have opted-out of Obamacare, either by paying the uninsured tax (6.5 million) or by filing a hardship exemption (12.7 million).
• 18 million enroll in Obamacare – Roughly 18 million have enrolled, including about 11 million on government exchanges and almost another 7 million off exchanges.
• Many who enroll in Obamacare cancel their coverage – By some estimates, more than 20% of those who do enroll in Obamacare cancel their plans during the year. Some consumers who purchased coverage on state-run exchanges have seen their plans cancelled for unknown reasons.
• Many doctors don’t get paid by patients on Obamacare – According to the Great American Physician Survey, 45% of doctors with patients on Obamacare have problems collecting large deductibles from patients, and 24% see claims denied because patients’ don’t pay their premiums.

Q: What is the Federal Invisible High Risk Sharing Program?

A: The Federal Invisible Risk Sharing Program is essentially a pool of money set aside by the federal government to help insurance companies cover high medical cost individuals.

These risk pools differ from many risk pools used in the past because they’re invisible to the customer. In other words, high medical cost individuals typically would not know they’re in the risk pool.

Assuming they have maintained continuous coverage, such individuals are expected to pay the same price for their health insurance as people who are healthy.