Senate Health Care Bill Would End Mandates, Change Tax Credits

Senate Republican leaders released the details of their bill to repeal the Affordable Care Act (ACA) and replace it with a version that would end employer and individual mandates while changing the way tax credits are offered to help people buy coverage.

In an overview of the proposal announced this morning, Senate GOP leaders said their version of health care reform would change Medicaid an open-ended government entitlement program to a system of capped federal payments that limit federal spending. The bill would repeal billions of dollars in taxes used to raise money for Medicaid expansion under the ACA.

The health law’s tax credits to help people buy private coverage would be kept but reshaped so that they are less generous and cost the government less money.

Other highlights of the proposal include:

• Establishing a Short-Term Stabilization Fund to help balance premium costs and promote more choice in insurance markets throughout the country. This fund would provide $15 billion per year in 2018 and 2019; $10 billion per year in 2020 and 2021.
• Continuing federal cost-sharing reductions through 2019 to help lower health care costs for low-income Americans in the individual market.
• Establishing a Long-Term State Innovation Fund of $62 billion, over eight years, to encourage states to assist high-cost and low-income individuals to purchase health insurance by making it more affordable.
• Adjusting tax credits for income, age and geography.
• Expanding health savings accounts and increasing contribution limits to help pay for out-of-pocket health costs and over-the-counter medications.
• Repealing taxes on health insurance, prescription drugs, medical devices, and “high-cost” employer sponsored plans.
• Allowing states a waiver to opt out of major parts of the ACA and create their own health care rules. The bill would alter what was known as 1332 waivers under the ACA and make them easier to obtain. However, states would not be allowed to waive the ACA requirements that insurers accept everyone and charge the same rates, with few exceptions.
• Continuing access to care for those with pre-existing conditions, and allowing children to stay on their parents’ health insurance through age 26.