The Republican party has just released their healthcare bill and really, it isn't a replacement, more like an alteration of Obamacare. There's no full repeal, but just tinkering with definitions, you know the usual way DC get's things done.
- Gives subsidies illegal immigrants if they are working in the United States
- Subsidies based on 350% Federal Poverty Level, not 400%.
- Gets rid of business and consumer mandates with no penalty
- Qualified plans don't need to provide abortion coverage unless it's to save the life of the mother
- Each state gets 15-10 Billion for uninsurables
- Cadillac tax is gone
- OTC med tax is gone
- HSA penalty tax is 10%
- Prescription tax is gone
- Medical device tax is gone
- Business owners can deduct part d expense again
- Deductible medical expenses are back to 7.5% instead of 10% AGI
- Tanning tax is gone (ironic)
- Net investment tax is gone
- HSA deductibility will be adjusted every year for COLA
- Both spouses can now make catch-up contributions to a family HSA
- 60 day limitation to setting up an HSA account when first getting the plan for purposes of a current claim
- No coverage for abortion clinics
- Repeal of cost-sharing subsidy
- MLR set by states
- Grants for states battling opiod addiction (like mine)
- CHIP is reauthorized
- $5,000 app fee to create small business association health pool
- Psychiatric coverage is limited to institutionalized individuals only, and for stays up to 30 days but not to exceed 90 days
Some additional details:
- Funds two years of current Obamacare payments to insurers (which President Trump has repeatedly threatened to pull) to stabilize the insurance marketplace.
- Delays cuts to Medicaid.
- Eliminates Obamacare’s individual mandate and doesn’t include penalties for a lapse in coverage.
- Allows children to stay on parents’ plans through the age of 26.
- Does not include the House bill language to waive essential health benefit coverage, but does give states the ability to opt out of other Obamacare rules.
Recapping the House bill
- Prevents women from using federal tax credits to buy plans that cover abortion and temporarily blocks Planned Parenthood from receiving federal funds for one year.
- Lets states impose work requirements for Medicaid.
- Allows states to seek waivers from covering essential health benefits – including maternity care and emergency room trips.
- Allows states to waive an Obamacare regulation that prevented insurers from charging sicker consumers more, which would effectively undermine pre-existing conditions protections.
- Repeals Obamacare’s individual mandate but penalizes people who let their coverage lapse for 63 days.
- Replaces Obamacare’s income-based tax credits with age-based tax credits that don’t vary with local insurance costs.
- Adds $8 billion to high-risk pools for Americans with pre-existing conditions.
Going forward, per ABC
The bill’s release follows months of speculation and contentious debate. Senate Democrats have criticized their Republican counterparts for working on the bill behind closed doors. Earlier this week, Sen. Al Franken, D-Minn., appearing on ABC News’ “Powerhouse Politics” podcast, noted that when crafting the Affordable Care Act, Republicans had a chance to offer changes.
“In the Health Committee, I think 160 Republican amendments were accepted into the bill,” he said. “It was debated for 25 straight days before it was voted on. It was scored well in advance. This is a sham.”
The Congressional Budget Office, which provides nonpartisan, quantitative analyses to Congress, will now evaluate the bill. A CBO score could come as soon as Friday.
The CBO estimated that the version of the American Health Care Act passed by the House would leave 24 million more Americans uninsured by 2026 than under the Affordable Care Act. The office also estimated the bill would reduce federal deficits by $337 billion from 2017 to 2026.