What’s Happening with the Health Care BillDifferences from the ACA, AHCA, BCRA and What’s Next
What’s Happening with the Health Care Bill
Differences from the ACA, AHCA, BCRA and What’s Next
On July 13, 2017, the Senate revealed their version of the already House-passed American Health Care Act (AHCA). The Better Care Reconciliation Act (BCRA) made some significant updates, but on July 18 the legislation was determined to not have the support it needed to pass the Senate.
This latest hurdle in the GOP’s promise to repeal and replace Obamacare sparked discussion about passing a “repeal now, replace later” legislation. However, after a late night meeting on July 20, the Republican Party is more optimistic that a version of the BCRA will come to pass.
Senate Majority Whip John Cornyn said “I’m more optimistic that that [some version of the Better Care Reconciliation Act coming back] would be the case. But if there’s no agreement, then we’ll still vote on the motion to proceed, but it’ll be to the 2015 just-repeal bill.”
With the uncertainty and changes within in the current political landscape, it is easy to lose track of policies that are being debated. Outlined below are some of the key points of disagreement, and how each bill addressed those challenges.
Tax credits under the ACA are based on income, age and geography.
The AHCA includes an advanceable tax credit based on age and family size.
The BCRA takes into account income level, and geography as well as age. However, the plan is more selective than the ACA, so people need to make less money than before to receive them.
Coverage and cost cannot be dependent on pre-existing conditions according to the ACA.
Under the AHCA, $8 billion is allocated to fund high-risk pools. Pools provide coverage if you have been locked out of the individual insurance market because of a pre-existing condition, and are subsidized by a state government. The premium is up to twice as much as individual coverage.
Coverage and cost cannot be dependent on pre-existing conditions according to the BCRA.
The ACA requires Americans to have health coverage, if they don’t they must pay a fine. There is also an employer mandate requiring large companies to provide health insurance for their employees.
Under the AHCA, the mandate is eliminated, but insurers are allowed to inflict a surcharge on consumers who purchase a new plan after letting their previous coverage lapse. The employer mandate is completely eliminated.
Instead the premium surcharge outlined in the AHCA, the penalty for people who had a break in coverage is having to wait six months before getting new coverage. The employer mandate is also still eliminated.
The ACA expanded Medicaid with enhanced federal match for expansion population.
The ACA’s plan to grow Medicaid is halted. Along with other limitations, new enrollment freezes in 2020 under the AHCA.
Under the BCRA, federal contribution is based on general state match percentage starting in 2023.
The ACA requires insurance to offer 10 essential health benefits. Essential health benefits include prescription drugs, maternity care, emergency services, and mental health care.
Under the AHCA, if a person did not maintain continuous coverage, states may apply charge sick people more or drop essential benefits.
According to the BCRA, states may apply for waivers to drop essential benefits, but coverage cannot be sold for more or denied to people who are sick.
There are a lot of questions up in the air about the future of health care under the Trump Administration. All that can be concluded for sure is that change is coming. To stay up to date on new rules, regulations and policies under the new administration, medical industry leaders can gather at conferences or join our mailing list for regular updates.