Who Gains and Who Loses under the American Health Care Act

Congress is currently considering passage of the American Health Care Act (AHCA). This bill would repeal large portions of the Affordable Care Act, including most of its sources of revenue, and would introduce significant changes to the Medicaid program and the private nongroup insurance market. We use the Urban-Brookings Tax Policy Center Microsimulation Model and The Urban Institute Health Policy Center’s Health Insurance Policy Simulation Model (HIPSM) to allocate changes in taxes and federal health benefits across families grouped by income. We find that the AHCA’s changes to federal taxes and health care benefits would be very regressive: that is, taking both tax reductions and benefit reductions into account, the average high-income family would be significantly better off and the average low-income family would be significantly worse off under the AHCA.