The Senate Health Care Bill

Yesterday, Senate Republican leaders released a discussion draft of their version of health-care legislation, the Better Care Reconciliation Act (BCRA). Senate Majority Leader Mitch McConnell plans to put this legislation to a vote next week with the expectation of passing it. The Senate Republican plan is best understood as a GOP amendment to the existing Affordable Care Act (ACA). Indeed, one could imagine that, back in 2009, if the Republicans had attempted to modify rather than defeat the ACA, this is the kind of amendment they would have offered. The BCRA repeals most of the tax hikes of the ACA, cuts back substantially on the spending in the ACA, eliminates enforcement of the ACA’s individual and employer mandates, and provides more space for state decision-making and initiative. Even with these changes, much of the ACA’s structure is left in place. The following is a condensed summary of the main features of the Senate proposal with some thoughts about the bill’s likely effects. Building on the ACA’s Tax Credits The House-passed American Health Care Act (AHCA) would repeal the ACA’s premium credits, which are adjusted based on household income, and replace them with age-adjusted tax credits that are not scaled to income except for households with incomes above $75,000 per year. Senate Republicans have chosen to use the ACA’s premium credit structure as their starting point rather than the AHCA’s age-adjusted credits. The Senate legislation would make thre...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Following the ACA Insurance and Coverage Medicaid and CHIP Source Type: blogs