Senate Republicans finally revealed on Thursday the health care bill they have been working on in secret, which is designed to replace the Affordable Care Act, known colloquially as Obamacare.
The bill contains several departures from the American Health Care Act that the House passed earlier this year. It is part health insurance reform and part Medicaid reform.
Here’s what the bill contains:
- Medicaid would be cut and capped starting in 2025. Starting in 2020, states would have a choice between accepting one large, capped block grant or accepting a predetermined funding per recipient. However, Medicaid spending would continue to grow at its current level until then.
- Obamacare’s Medicaid expansion would be phased out starting in 2020 and would be completely phased out by 2023. 14 million people received insurance coverage through Medicaid expansion.
- States could add a work requirement for able-bodied adults in order to receive Medicaid benefits.
- The Obamacare subsidies to help people purchase health insurance remain mostly intact, except they would be limited to those making at or below 350 percent of the federal poverty level. Currently, subsidies are given to those making 400 percent of the Federal poverty level.
- $110 billion would go to states to help people afford health insurance premiums and help address gaps in health insurance coverage. $50 billion of that amount would be used to bail out insurers and encourage them to continue to participate in the exchanges.
- Obamacare’s preexisting conditions protections remain completely intact.
- The individual mandate is merely set at $0 instead of being repealed completely. This makes it easier for a future Congress to increase it.
Long story short, this bill is merely Obamacare-Lite. It keeps the overall structure intact. It also sets deadlines far into the future so they can be changed by future Congresses.
Not only that, free-market ideas such as buying insurance across state lines and association health plans, which allow small businesses to band together to buy insurance for their employees, were left out of the Senate bill.
Senate Republicans and their allies will make the excuse that all of these had to be left out under the Senate’s reconciliation rules, which only require 51 votes to pass instead of 60 votes. However, much of Obamacare passed through reconciliation. Republicans could simply change the rules if they wanted to insert free-market provisions. They could get rid of the 60 vote filibuster or change the reconciliation rules. But they didn’t, which shows the true priorities of the Senate Republicans.
Is this bill better than Obamacare? We’ll leave it to the reader to decide. However, this bill cannot be accurately described as an Obamacare replacement, since it leaves so much of the current law intact.