How does the health bill being debated in the Senate compare to the one that narrowly passed the House last month? How do they compare to the Affordable Care Act’s rules currently in place? Here’s a breakdown of how these bills handle the main tenets of health care reform.
The Senate bill is a little friendlier to the Medicaid expansion included in the Affordable Care Act than the House’s. While the House bill would end Medicaid expansion in 2020, the Senate bill continues the expansion for three years, then begin rolling it back in 2021. Both the House and Senate bills would put Medicaid on a capped budget, by delivering states funds in one of two options – a block grant, or a figure based on the number of enrollees.
Pre-Existing Conditions and Essential Health Benefits
Both the House and Senate bills give a lot of power to the states to opt out of prohibiting insurers from charging individuals more based on their health.
Additionally, both bills allow the states to redefine the “essential health benefits” established by the Affordable Care Act.
Affordable Care Act Taxes
The ACA is paid for in large part by two new taxes on America’s highest-earners. Both the House and Senate bills eliminate those taxes.
Subsidies to Pay for Plans
The ACA provides subsidies to defray the cost of insurance to individuals based on community rating, age, and income. The Senate removes age from that calculation, while the House bill is based entirely on age.
One of the most controversial elements of the ACA, the law requires all Americans to have health insurance or pay a penalty. This mandate is removed in both the House and Senate bills, though the House does inflict a surcharge on individuals who allow coverage to lapse and then sign on again.
Stay on Parents Insurance Until 26
All three bills retain the rule allowing young people to stay on their parents insurance until age 26.
Maintaining the Marketplace
The Senate bill does include provision of $50 billion to help stabilize insurance markets and hold down premiums from 2018 through 2021.
The Congressional Budget Office is expected to score the Senate bill this weekend, and the bill could come to the floor for a vote as early as next week.