Obamacare vs Trumpcare

See a side-by-side comparison of the two Acts / ACA & AHCA

Obamacare Vs Trumpcare

See a side-by-side comparison of the two Acts / ACA & AHCA

obamacare vs Trumpcare

This information is a study on both plans, (Trump Care Vs Obamacare) the current Affordable Care Act and proposed American Health Care Act. In this analysis, we will compare both plans and what the changes mean for our American citizens regarding their future health coverage. Discussed near the end will also provide low cost alternatives to help the American citizens receive health coverage at a lower cost as well as prospective plans that could lower the overall cost of healthcare by using services offered by United States companies and nonprofit organizations.


Obamacare Vs Trumpcare

Certain areas throughout the American Health Care Act made impacting changes to what we are used to with the Affordable Care Act. Below, we state how both Acts will effect certain areas, in relation to healthcare, side-by-side. Trump Care Vs Obamacare

Obamacare vs trumpcare on the Individual Mandate


Affordable Care Act / Obamacare

Qualifying coverage

Require U.S. citizens and legal residents to have qualifying health coverage. Individuals without coverage pay a tax penalty of the greater of $695 per year, indexed by inflation, or 2.5% of household income. Exemptions granted for affordability, financial hardship, religious objections, other reasons.

What Trump Care Changes

Tax Penalty

Tax penalty for not having minimum essential coverage is eliminated effective January 1, 2016

Late enrollment

Late enrollment penalty (30% of otherwise applicable premium) applies for individuals buying non-group coverage who have not maintained continuous coverage.

Obamacare vs trumpcare on Premium Subsidies to individuals

Affordable Care Act / Obamacare

Tax Credits

Provide refundable, advanceable premium tax credits to eligible individuals with incomes between 100-400% FPL to purchase insurance through the exchanges. Credits computed on sliding scale so people pay no more than a required percentage of income for the second lowest cost silver plan for their age in their area. Credit amount decreases as income increases; amount increases as cost (including age-rated premium) of benchmark plan increases.


Annually index individual required contribution by premium growth over income growth through 2018.


U.S. citizens and legal immigrants who meet income limits and who are not eligible for affordable coverage through an employer or public program are eligible for tax credit. Premium tax credit can be applied to any individual health insurance policy, other than catastrophic policies, sold through the exchange.Individuals who are eligible for public programs, including Medicare, Medicaid, CHIP, or for employer sponsored coverage that meets affordability and minimum value standards are not eligible for tax credit.

What Trump Care Changes

Tax Credit modifications

For 2018-2019, modify premium tax credits as follows:

  • Increase credit amounts for young adults with income above 150% FPL and decrease amounts for adults 50 and older above that income level.
  • For end of year reconciliation of advance credits, the cap on repayment of excess advance payments does not apply.
  • Tax credits cannot be used for plans that cover abortion.
  • Premium tax credits can be used to purchase catastrophic plans.
  • Premium tax credits can be used to purchase qualified health plans (i.e., covering essential health benefits) sold outside of the exchange, but are not advance-payable for such plans. Premium tax credits cannot be used to purchase grandfathered or grandmothered individual health insurance policies sold outside of the exchange.
Tax credit replacement

Starting in 2020, replace ACA income-based tax credits with flat tax credit adjusted for age. Credits are payable monthly; annual credit amounts are:

  • $2,000 per individual up to age 29
  • $2,500 per individual age 30-39
  • $3,000 per individual age 40-49
  • $3,500 per individual age 50-59
  • $4,000 per individual age 60 and older
Credit claims


Families can claim credits for up to 5 oldest members, up to limit of $14,000 per year.





Amounts are indexed annually to CPI plus 1 percentage point




U.S. citizens and legal immigrants who are not incarcerated and who are not eligible for coverage through an employer plan, Medicare, Medicaid or CHIP, or TRICARE, are eligible for tax credit. Married couples must file jointly to claim the credit. In addition, eligibility for the tax credit phases out starting at income above $75,000 (credit is reduced, but not below zero, by 10 cents for every dollar of income above this threshold; tax credit reduced to zero at income of $95,000 for single individuals up to age 29, $115,000 for individuals age 60 and older. For joint filers, credits begin to phase out at income of $150,000; tax credit reduced to zero at income of $190,000 for couples up to age 29; tax credit reduced to zero at income $230,000 for couples age 60 or older; tax credit reduced to zero at income of $290,000 for couples claiming the maximum family credit amount.)



tax credit reduction

Taxpayers who are also enrolled in qualified small employer health reimbursement arrangements (HRA) that apply to non-group coverage will have tax credit reduced, but not below zero, by the amount of the HRA benefit.



excess credits


Excess credit amounts (above the actual cost of individual coverage or COBRA policy) are payable to health savings accounts.





Obamacare vs trumpcare on Cost sharing subsidies to individuals

Affordable Care Act / Obamacare


Provide cost-sharing subsidies to eligible individuals with household income between 100%-250% FPL. Subsidies reduce deductibles, copays and OOP limit that otherwise apply under silver plans by increasing actuarial value of plan on sliding scale.

What Trump Care Changes


If you are on a cost sharing subsidy you will purchase plans with non reduced limits and reflect the full plan summary instead of adjustments to deductible, coinsurance, copays, etc.

Obamacare vs trumpcare on Individual health insurance market rules

Affordable Care Act / Obamacare

guaranteed issue

Require guaranteed issue of all non-group health plans during annual open enrollment (3 months for 2017 plan year). Insurers also must offer 60-day special enrollment periods (SEP) for individuals after qualifying events. Small group health insurance plans must be guaranteed issue year round. Require insurers to set prices to reflect expected costs for single risk pool.

Rating variation

Rating variation permitted for just 4 factors: age (limited to 3 to 1 ratio), geographic rating area, family composition, and tobacco use (limited to 1.5 to 1 ratio). Prohibit pre-existing condition exclusions.

What Trump Care Changes

Age Rating

Age rating of 5:1 is permitted starting January 1, 2018, unless states adopt a different ratio.

Obamacare vs trumpcare on Women’s health

Affordable Care Act / Obamacare



Require all plans offered in the individual and small group markets to cover ten categories of essential health benefits including maternity care and preventive care, such as contraception and cancer screenings.

Pre-existing conditions


Prohibit pre existing conditions exclusions which historically have included pregnancy, prior C-section, and history of domestic violence.

descriminated premiums

Prohibit discriminatory premium pricing based on gender (gender rating).

abortion coverage

Prohibit abortion coverage from being required. Federal premium and cost-sharing subsidies cannot pay for abortion beyond saving the life of the woman or in cases of rape or incest (Hyde amendment). If a subsidy-eligible individual enrolls in a plan that chooses to cover abortion services federal subsidy funds must be segregated from private premium payments or state funds.

provider descrimination

Prohibit plans from discriminating against any provider because of an unwillingness to provide, pay for, provide coverage of, or refer for abortions.

What Trump Care Changes

Planned Parenthood

Prohibits federal Medicaid funding for Planned Parenthood clinics for one year, effective upon date of enactment. Specifies that federal funds to states including those used by managed care organizations under state contract are prohibited from going to such entity.

abortion services

Redefine qualified health plan to exclude any plan that covers abortion services, beyond those for saving the life of the woman or in cases of rape or incest (Hyde amendment), effective in 2018

tax credits: abortions

Prohibit federal premium tax credits from being applied to plans that cover abortion services, beyond Hyde limitations. Disqualify small employers from receiving tax credits if their plans include abortion coverage beyond Hyde limitations, effective in 2018. Does not prevent an insurer from offering or an individual from buying separate policies to cover abortion as long as no tax credits are applied.

Obamacare vs trumpcare on High risk pools

Affordable Care Act / Obamacare

high-risk pool

Create a temporary national high-risk pool to provide health coverage to individuals with pre-existing medical conditions 2010-2013


What Trump Care Changes

high-risk pools

States may use Innovation and Stability Program grants to fund high-risk pools, and for other purposes



House Republicans are carrying out legislation to deliver relief from Obamacare’s taxes and mandates to completely lay out the foundation for a 21st century health care system.

Specifically, the primary Committees with jurisdiction over health care—Ways and Means and Energy and Commerce—have released legislation that not only repeals the law, but replaces it with reforms President Trump laid out.

Taken together, here’s what the three combined legislation will attempt to accomplish:



Eliminate the individual / employer mandate penalty

that forced millions of workers, families, and employers into expensive Obamacare plans that they cannot afford.

Dismantles the Obamacare taxes

that have hurt job creators, increased premium costs, and limited options for patients and health care providers—including taxes on prescription drugs, over-the-counter medications, health-insurance premiums, and medical devices.



Help young adults access health insurance

And stabilize the market by enabling dependents till they’re 26 to carry on remaining on their parents’ plan.

Prohibit health insurers from denying coverage

or charging more money to patients based on pre-existing conditions.


Establish a Patient and State Stability Fund

which provides states with $100 billion to design programs that meet the unique needs of their patient populations and help low-income Americans afford health care

Modernize and strengthen Medicaid

by transitioning to a “per capita allotment” so states can better serve the patients most in need.

Empower individuals and families

to spend their health care dollars the way they want and need by enhancing and expanding Health Savings Accounts (HSAs)—nearly doubling the amount of money people can contribute and broadening how people can use it.

Help Americans access affordable, quality health care

by providing a monthly tax credit—between $2,000 and $14,000 a year—for low- and middle-income individuals and families who don’t receive insurance through work or a government program.

View / download the bill

American Health Care Act

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