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Passage by the upper chamber is no sure thing
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On June 22, the Senate released
its version of the American Health Care Act, a measure to repeal and replace key sections of the Affordable Care Act (ACA). The
House passed its version of the bill on May 4. If the Senate passes the measure, which is not expected to receive any Democratic support, the Senate and House versions would need to be reconciled by a joint committee.
Senate Health Care Bill Would End Employer Mandate Penalty, Keep 'Cadillac Tax'
The Senate's Better Care Reconciliation Act (BCRA), like its House counterpart, would maintain but delay until 2026 the Cadillac tax on high-cost health benefits. Some annual ACA reporting by employers would stay but reporting would be less burdensome without the employer mandate penalties and with relaxed coverage requirements. Annual contribution limits for health savings accounts (HSAs) would nearly double and limits on employee contributions to flexible spending accounts (FSAs) would fall away.
Subsidies Would Be Tied to Income, Not Age
The Senate proposal largely mirrors the House measure with significant differences. While the House legislation would peg federal insurance subsidies to age, the Senate bill would link them to income, as the ACA does. The bill also proposes repealing all the ACA taxes except for its "Cadillac tax" on high-cost health plans in language similar to the House version. Senators had previously toyed with the idea of keeping some of the ACA's other taxes.
Still Lots of Questions
GOP senators trickling out of an all-conference meeting Thursday morning said while the reaction was broadly positive, the bill's backers will still need to win over a host of still-skeptical lawmakers. Majority Leader Mitch McConnell of Kentucky is pushing for a vote as early as June 29, ahead of Congress' July 4 recess. He will need the support of at least 50 of the chamber's 52 Republican senators to pass the bill, and several this week said they're withholding their support until they see final legislation. (Politico)
No Higher Premiums for Pre-Existing Conditions
The Senate also backs away from some last-minute House concessions to conservatives that would have allowed states to opt out of several protections for those with pre-existing conditions. The bill would prohibit insurers from charging higher premiums to those with pre-existing conditions. The Senate bill would also largely maintain the ACA's premium subsidies structure, but tighten the eligibility criteria starting in 2020. Only those earning up to 350 percent of the poverty level would qualify, rather than the 400 percent threshold contained in the ACA. But it would also open up the subsidies to enrollees below the poverty level so those living in states that didn't expand Medicaid could get some assistance. (CNN.com)
What's Next for Health Care Repeal Efforts?
Employers want to know what's happening with health care reform and the promises that President Donald Trump made during his campaign to repeal and replace the Obama-era ACA. But even if the Senate moves forward, it will be a while before there's a final outcome because the Senate and the House will likely go back and forth with modifications.(SHRM Online)
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