Speed Read: The House Obamacare Replacement Bill

Ken AshfordHealth Care, Trump & AdministrationLeave a Comment

From Axios:

The House Republican Obamacare replacement package is finally out, and the two main health care committees — Ways and Means, and Energy and Commerce — are scheduled to start working on the bills on Wednesday. Here’s your speed read on what’s in them — summaries are available here and here:

In:

  • Pre-existing condition coverage
  • Continuous coverage — 30 percent penalty if people don’t keep themselves insured
  • Special fund to help states set up “high-risk” pools, fix their insurance markets, or help low-income patients
  • Enrollment in expanded Medicaid will be frozen
  • Current enrollees can stay until 2020, and keep getting extra federal funds, until they leave the program on their own
  • Medicaid will change to “per capita caps” (funding limits for each person) in fiscal year 2020
  • A new, refundable tax credit will be available in 2020 to help people buy health insurance
  • Covers five age groups — starts at $2,000 for people in their 20s, increases to $4,000 for people in their 60s
  • It’s not means tested, but phased out for upper-income people (starting at $75,000 for individuals, $150,000 for families)
  • Insurers can charge older customers five times as much as young adults

Out:

  • All Obamacare taxes
  • All Obamacare subsidies, including its premium tax credit
  • Individual, employer mandate penalties
  • “Cadillac tax” (until 2025)
  • No longer will limit the tax break for employer-sponsored health coverage
  • No payments to insurers for cost-sharing reductions
  • Selling insurance across state lines (can’t be done in the “reconciliation” bill)
  • Medical malpractice reform (can’t be done in the “reconciliation” bill)

There’s also a little sugar in there for insurance company CEOs. Under Obamacare, insurance companies could not deduct an employee’s pay that exceeded $500,000 per year.  This limited incentives to give excessive salaries to CEOs and officers.  That limitation is gone now.

Look, if this is complicated for you (and no shame in that — it’s hard stuff) consider this: the House did not send this to the Congressional Budget Office for “scoring”. In other words, we would normally get an estimate as to (1) how much this will cost or save (will it add to the deficit?); (2) how many people will get lose coverage; and (3) how much insurance costs will go up (or down) as a result for the average consumer.  The House did not get the bill “scored” because — let’s face it — they didn’t think the numbers would look good.

AND they are trying to get this passed without debate.

My prediction? Even if they succeed in passing the bill, it is DOA in the Senate.