Senate Version of Obamacare Repeal Released

On Wednesday, June 22, the U.S. Senate Obamacare repeal legislation was released and is similar to the Affordable Health Care Act that passed the U.S. House of Representatives in April. Senate Majority leader McConnell has signaled that the legislation will reach the Senate floor for a full vote before the 4th of July recess.On Wednesday, June 22, the U.S. Senate Obamacare repeal legislation was released and is similar to the Affordable Health Care Act that passed the U.S. House of Representatives in April. Senate Majority leader McConnell has signaled that the legislation will reach the Senate floor for a full vote before the 4th of July recess.

Below is a summary and reference that compares Obamacare to the House and Senate repeal legislation.

I. Employer Mandate 

a. Obamacare: Currently, under Obamacare, the employer mandate requires businesses that meet the 50 employee threshold to provide health insurance for their employees.

b. House and Senate Versions: If either the House and Senate version is enacted into law, pest management businesses would no longer have to offer health insurance coverage for their employees if they meet the 50 employee threshold.

II. Tax Credits 

a. Obamacare: Currently, under tax credits to help purchase insurance are primarily based on income, age and geography, which benefits lower- and moderate-income people buying coverage through the marketplaces.

b. House Version: The House bill would base tax credits on age.c. Senate Version: Tax credits would be primarily based on age, income and geography. The credits would be used to cover a less generous plan, and people would need to be lower-income than under Obamacare to receive them.

III. Cost-sharing Subsidies 

a. Obamacare: Cost-sharing subsidies were provided to insurers to help some of their Obamacare customers cover deductibles and co-payments.

b. House Version: These subsidies would end in 2020, although the President has the authority to end them earlier.

c. Senate Version: These subsidies would end in 2020, although the President has the authority to end them earlier.

IV. Pre-existing Conditions 

a. Obamacare: Insurance companies are not allowed to increase someone’s premiums or deny coverage based on pre-existing conditions.

b. House Version: States could allow insurers to increase someone’s premiums based on their preexisting conditions if they had a break in coverage. The state would have to set up some other program, such as a high-risk pool, to cover its sickest residents. The federal government would have its own $8 billion fund to help cover sick people’s high premiums within the individual market.

c. Senate Version: Insurance companies are not allowed to increase someone’s premiums or deny coverage based on preexisting conditions, though states may allow them to not cover costs associated with some conditions.

V. Health Savings Accounts (HSAs) 

a. Obamacare: Individuals can contribute up to $3,400 and families up to $6,750 to pretax health savings accounts.

b. House Version: Starting in 2018, individuals could contribute up to $6,550 and families could contribute up to $13,100 to pretax health savings accounts.

c. Senate Version: Allows people to put more money into their health savings accounts, up to the maximum allowed for out-of-pocket costs, and lets spouses make additional contributions.

VI. Medicaid Reform 

a. Obamacare: Medicaid is an entitlement program with open-ended, matching federal funds for anyone who qualifies.

b. House Version: Medicaid would be funded by giving states a per capita amount or block grant based on how much each state is spending, not adjusting for rising costs. Overall, this is expected to substantially decrease federal funding, according to the Congressional Budget Office’s report on the plan.

c. Senate Version: Medicaid would be funded by giving states a per capita amount or block grant, beginning in 2021. The amount would grow more slowly than in the House bill, meaning bigger spending cuts overall.

VII. Medicaid Expansion 

a. Obamacare: States can expand Medicaid to cover people making up to 138 percent of the poverty line, and the federal government would cover an outsize portion of their costs.

b. House Version: States would not be able to expand Medicaid after this year. In states that do expand by the deadline, the federal government will pay a smaller portion of the cost for people who sign up after 2019, making the expansion much more expensive for those states.

c. Senate Version: For states that expand Medicaid, the federal government would pay a smaller portion of the cost starting in 2021.