Back in early May, the U.S. House of Representatives passed a piece of budget reconciliation legislation called the American Health Care Act (AHCA), intended to be Republicans’ first step in repealing and replacing the Affordable Care Act (ACA). The next stop for the bill was the Senate where it would receive an overhaul and be put to a vote.
On June 22, 2017, Senate Republicans released their proposed substitute to the AHCA, the Better Care Reconciliation Act of 2017. The Senate’s revised bill differs from the House’s AHCA in a few distinct ways, but not as much as many people had speculated.
Like the House bill, the Senate bill would eliminate the penalties for failure to comply with the employer and individual mandate. The revised bill also includes incentives to increase the use of health savings accounts (HSAs), such as greater flexibility on eligible expenses and increased contribution limits.
The “Cadillac” excise tax on high-cost employer plans would be delayed from 2020 to 206. Taxes on health insurance, medical devices, and prescription drugs would be repealed.
Several Senators from states in favor of the Medicaid expansion expressed concerns about the roll-back of that funding in the House bill. As a result, the Senate’s proposed legislation allows for a longer transition period.
The Senate bill proposes heftier subsidies to help people who can’t afford health insurance. It also allows for adjustments based on age, income, and geography.
The Senate also plans to continue to fund the ACA’s cost-sharing reductions to helper lower out-of-pocket expenses for low-income individuals. However, the outcome of this dispute is still unclear, as a pending lawsuit in the House challenges whether these subsidies are legal.
While those aren’t the only changes to the House bill, they’re some of the most widely debated. It now remains to be seen whether the Senate’s attempt to mainstream the bill will be sufficient to garner the simple majority it needs to pass.
Majority Leader McConnell plans to bring the bill to a vote prior to the Senate’s recess on July 4th. If it passes, the next stop will be the House of Representatives for yet another vote before landing on President Trump’s desk to be signed into law. We’ll keep you posted on the outcome.