- The Affordable Care Act (ACA) required all large employers to offer affordable coverage to their employees. The Senate bill proposes to eliminate that requirement.
- Similar to the House bill, the Net Investment Income Tax of 3.8% and the Medicare surtax of .9% would be repealed.
- The Senate bill continues to require that insurers offer coverage to those with pre-existing conditions and companies are not allowed to charge inflated premiums based on their medical history. However, states would be given the opportunity to waive those federal provisions and allow insurers to offer less comprehensive benefits.
- States will also be allowed to redefine “essential benefits”. Before The ACA, insurance companies could pick and choose what services would be covered under their policies. The ACA currently requires every health plan to cover “essential benefits” ranging from maternity care, prescription drugs and mental health.
- The Senate bill proposes to continue government subsidies for insurance premiums but will make subsidies available to fewer people. Currently, taxpayers are eligible for a subsidy if household income is no more than 400% above the poverty level. The threshold in this bill is reduced down to 350% and therefore less of the middle class will qualify. These premium tax credits will also be extended to those below the poverty level. Similar to the House bill, the plan aims to increase the credits for younger people and decrease the credits for older adults. One of the key differences between the proposed bills is that the House bill would base the subsidies on age and the Senate bill would base them on income and geography.
- Medicaid enhancements under ACA increased eligibility to 138% of the federal poverty level. Under the Senate bill, this Medicaid expansion will remain as it is until 2021 and then be phased out by 2024. This is a slowed down version of the House bill which would phase out the Medicaid expansion by 2020. Also, states would receive a fixed amount based on a per capita allotment rather than the flexible funding currently offered. Both the Senate and House bills would allow states the option to require work as an eligibility condition for nonelderly, nonpregnant, nondisabled adults.
- Planned Parenthood would be defunded temporarily by both the Senate and House versions of the health care bill. Specifically, Medicaid would be prohibited from funding Planned Parenthood clinics for one year.
- A minor adjustment was added on June 26th to the bill after the initial release. It is a provision to entice Americans to have continuing insurance coverage, as opposed to only purchasing insurance when they need it. There would be a six month waiting period for those that don’t have continuous coverage before they can be covered again. The House bill would allow insurers to impose a 30% surcharge to the on-again off-again policy holders, however the Senate bill would not.
- The Senate bill proposes to increase the annual tax deductible contribution limit on Health Savings Accounts for people in high-deductible plans. Currently the limit is $3,400 for individuals ($6,750 for family). The Senate bill would approximately double those amounts to $6,650 for individuals ($13,300 for family) to match the annual deductible and out-of-pocket expenses of the high-deductible health plan.
On Thursday, June 22, 2017, the U.S. Senate unveiled their version of the health care bill entitled The Better Care Reconciliation Act of 2017. Because of the narrow majority the Republicans have over Democrats in the Senate, if only 2 Republicans vote against it, it will be back to the drawing board. From the stir it’s made since it’s unveiling, changes will most likely need to be made before it would pass the Senate. If a version of this healthcare bill does pass the Senate, the House and Senate would need to reconcile their proposed bills and vote on a reconciliation bill before sending it the President for signature. While we anticipate more changes to come before we have a new law in place, here are a few of the key provisions of the Senate Bill as it is currently written.
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