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What to Expect in Senate’s Health Care Bill

GOP leaders pursue moderate votes

While Senate Republicans are busy drafting their health care plan behind closed doors, The Hill has speculated on where they might be headed. The article discusses six key initiatives that are likely to be included in the bill.

1. The phase-out of Medicaid expansion will be slowed down.

Senator Rob Portman (R-Ohio) has proposed a seven-year phase-down in the funding for the Medicaid expansion mandated by the Patient Protection and Affordable Care Act (PPACA), a timeframe backed by other centrists, according to the article. Senate Majority Leader Mitch McConnell (R-Kentucky) has proposed a three-year phase-down.

The Hill speculates that the final Senate bill might have something in between.

2. Tax credits will be beefed up.

Senator John Thune (R-South Dakota) has been working on a plan that directs more tax credit help to pay for insurance toward people with low incomes and older Americans. Sen. Thune told reporters that he has sent his proposed legislation to the Congressional Budget Office to be evaluated.

The House bill included tax credits ranging from $2,000 to $4,000 based on age, not income. Those credits would be phased out for people with an annual income of $75,000 and would end completely for those making $95,000 or more.

Sen. Thune’s tax credits would end eligibility sooner for people with higher incomes and make credits larger, tying them to age and income while giving older people more support, the article says.

3. Some PPACA taxes will remain intact––for now.

If Senate Republicans plan to win moderate votes by spending more on health insurance subsidies and by delaying the phase-out of Medicaid expansion under the PPACA, they will need to find a way to pay for it, The Hill points out. Therefore, it’s expected that some PPACA taxes will remain intact, at least for the short term.

The House bill retroactively repealed nearly all PPACA taxes to the start of 2017, but delayed the repeal of the Medicare surtax on high earners until 2023 and the implementation of the tax on high-cost health plans until 2026.

4. More funding will be allocated to fight the opioid crisis.

To appease senators who are worried about curtailing Medicaid expansion, which plays a key role in providing coverage for addiction treatment, the Senate bill is expected to allocate more money for the opioid crisis, but it’s unclear how much, according to The Hill.

Sen. Portman told reporters that he is working with Senate colleagues to provide governors with a “dedicated new funding stream” to ensure that people using expanded Medicaid resources to treat their addiction can continue to receive treatment as they work to get back on their feet.

5. Efforts will be made to stabilize PPACA exchanges.

While Republicans want to dismantle the PPACA, they also need to make sure the insurance remain relatively stable, The Hill says. This could include funding for a few years for the PPACA’s so-called “cost-sharing reduction” payments, which reimburse insurers for giving discounts to low-income customers.

The House bill funded these payments through 2020, and the Senate bill will likely do the same.

6. More funding will be allocated to pre-existing conditions.

The House bill dedicated $15 billion over nine years to allow states to create high-risk pools to help people with pre-existing conditions, in addition to a last-minute amendment that allocated $8 billion over five years to a fund to help with premiums and cost-sharing for this population.

There was also a $100 billion pool of money in the House bill to help states stabilize their insurance markets, which could be used to help people with pre-existing conditions.

But that isn’t enough for some Senators. Susan Collins (R-Maine), for example, told reporters that the House bill “grossly underfunds” high-risk pools, and that it would need at least $15 billion during its first year to work.

Source: The Hill; June 18, 2017.

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