Everyone’s talking about the healthcare bill House Republicans released Monday night as a replacement for the Affordable Care Act of 2010 (ACA). While it still has a journey ahead of it, the bill takes a decidedly different path in health policy. The Energy and Commerce and Ways and Means Committees are supposed to mark up the bill on Wednesday. Here’s the very least you need to know.
The individual mandate would be eliminated as would the penalties for not having insurance. For employers, the mandate was not eliminated, but the associated penalties for not providing coverage for workers were removed.
Essential health benefits, including coverage for mental health and addiction services, would no longer be required as of 2018.
Medicaid expansion would end in 2020. The legislation would let states keep the extra funding ACA provided for those already in the expansion program who stay enrolled.
Certain ACA taxes would be eliminated such as the “tan tax” on tanning salons and the medical device tax.
According to the Kaiser Family Foundation, the essential health benefits have not been changed by the new legislation.
Federal Medicaid funding would be set at a fixed amount rather than a match. Today, the federal government uses an open-ended matching formula and ends up paying anywhere from 50% to 73% of Medicaid costs.
Adult children could still stay on their parents’ plan until age 26.
Insurers would still not be able to charge more for pre-existing conditions—with the caveat that the enrollee would need to have previous continuous coverage or pay a 30% surcharge.
Insurance subsidies would be replaced with tax credits in 2020. Current ACA subsidies are based on income, but the bill proposes tax credits based on age with those under age 30 getting $2,000 and adults over 60 getting $4,000 in credits. The credits diminish with income and are capped by household.
Insurers could charge older people five times more for coverage than younger people, rather than the 3-to-1 ratio included in ACA.
Insurers could create cheaper plans with fewer benefits.
Health savings accounts would be encouraged with increased tax benefits.
High-risk pools would be created for those with significant health issues, who otherwise would be uninsurable.
Community health centers would receive $422 million in additional funding in 2017 under the legislation, coupled with a one-year freeze on funding for Planned Parenthood. Tax credits could not be used to purchase health insurance that covers abortion.
Editor's Note: This post was updated on March 9 to reflect the details of the employer mandate and the essential health benefits.