In this report, the authors analyzed a version of the American Health Care Act (AHCA), a bill proposed in the U.S. House of Representatives on March 6, 2017. The bill would have repealed many of the provisions of the Affordable Care Act (ACA) and replaced them with alternative reforms. The authors used RAND's COMPARE microsimulation model to assess how the AHCA would have affected such outcomes as health insurance enrollment, consumer out-of-pocket costs, and the federal deficit relative to the ACA. This analysis relies on the version of the bill dated March 6, 2017, with several updates to account for the March 20 "Manager's Amendment."

This analysis finds that the AHCA would have resulted in a reduction in health insurance enrollment of 14.2 million in 2020 and a reduction in health insurance enrollment of 19.7 million in 2026. While the magnitude of the estimated coverage reductions is smaller than those of the Congressional Budget Office (CBO), this analysis confirms CBO's general finding that the AHCA would have substantially reduced insurance enrollment relative to current law. Those without insurance under the AHCA would have tended to be older, sicker, and poorer than those currently uninsured.