The House is set to vote today on the American Health Care Act (AHCA), the GOP bill to repeal and replace the Affordable Care Act (ACA). If enacted, 24 million Americans would lose their health coverage. Here are four ways the AHCA, with the recent amendments, is an attack on older adults:

1. The AHCA Guts Medicaid: The AHCA would drastically change Medicaid and harm older adults by cutting over $800 billion in federal funding, eliminating Medicaid expansion for adults ages 55 – 64, and weakening beneficiary protections. Under the AHCA, older adults and people with disabilities who rely on Medicaid would have fewer benefits and services, reduced access to home and community-based services, and receive less help paying for Medicare premiums or cost-sharing. States would be forced to make other cuts to Medicaid and other safety net programs as they will not have adequate funding to meet the needs of their aging populations.

2. The AHCA Weakens Medicare: The AHCA would undermine the Medicare program’s finances and threaten access to needed services for people with Medicare. The AHCA would reduce funds for Medicare, while providing tax breaks to the wealthiest Americans. This reduction would lead to the Trust Fund’s insolvency up to four years earlier than projected under the ACA.

3. The AHCA Imposes an “Age Tax:” Under the ACA, insurers can charge older adults no more than three times as much for their premiums as they can charge younger adults. The AHCA would allow insurers to charge older adults five times more, subjecting older adults to what AARP calls an “age tax”. Under the MacArthur Amendment, it appears states could waive the limit and charge older adults even more than the AHCA’s 5:1 limit. So, premiums would rise even higher for seniors.

4. The AHCA Eliminates Protections for People with Preexisting Conditions: The new changes proposed by Rep. MacArthur and Rep. Upton would return the individual market to the pre-ACA days when older adults and those with preexisting conditions could not afford health coverage. States that choose to operate a program for “high-risk” individuals could allow insurers to charge consumers who do not maintain continuous coverage more based on their health status. This would gut protections for people with preexisting conditions, including 25 million people aged 50-64, cause premiums to skyrocket, and leave those who need coverage the most without affordable options. The Upton Amendment does not solve this problem, but instead, provides an incentive for states to waive these protections. For additional information on The Dangers of the AHCA for Older Adults, see Justice in Aging’s Fact Sheet. For more on how cutting Medicaid funding harms older Americans, see Justice in Aging’s Fact Sheet and Issue Brief.