The House on May 4 approved, by a 217 to 213 margin, the American Health Care Act (AHCA) (HR 1628), a repeal and replacement plan for the Affordable Care Act (ACA). The AHCA, as approved, would eliminate most of the ACA’s taxes, including the penalties connected with the individual and employer mandates. The House bill now moves to the Senate where significant changes are expected to be made.

The major differences between the original House AHCA bill that was pulled from a floor vote on March 24 and the final version largely involve non-tax changes. Nevertheless, acceleration of the repeal of many tax provisions, including the net investment income (NII) tax, to January 1, 2017, is the most prominent exception. Non-tax changes, among others, include revisions that impact coverage of pre-existing conditions, the definition of essential health benefits, and other efforts to control rising premiums.

“The House has put the ball in play and what happens going forward is unknown,” Edward Leeds, Counsel, Ballard Spahr, Philadelphia, told Wolters Kluwer. “I expect the Senate will move slowly.”