Following the May passage in the House of the American Health Care Act (AHCA), the Senate has now released the text of its own draft Affordable Care Act (ACA) reform bill.
Dubbed the “Better Care Reconciliation Act of 2017,” the 142-page Senate proposal is substantively quite similar to the AHCA—including its elimination of the employer and individual mandates—with a few distinctions. Among other provisions, the Senate proposal:
- Reduces the income level required to qualify for premium tax credits. Currently, under the ACA, those earning 400% of the federal poverty level are eligible; the Senate proposal drops this to 350%. The tax credits would also cover leaner plans than they do now.
- Rolls back the existing Medicaid expansion more slowly, but ultimately more drastically, than does the AHCA.
- Allows states to opt out of most of the ACA’s coverage requirements, including those relating to maternity care, emergency services, and mental health; the AHCA also allows states to do this.
- Prohibits insurers from denying coverage or increasing premiums due to preexisting conditions. This is the current state of affairs under the ACA; the AHCA introduces an exception for those with coverage gaps.
- Provides for a 1-year defunding of Medicaid reimbursements to Planned Parenthood, as does the AHCA.
- Maintains, as does the AHCA, the popular ACA provision that dependents may remain on their parents’ coverage through age 26.
Senate majority leader Mitch McConnell hopes to hold a vote on the proposed legislation before the Senate breaks for its July 4th recess.
It is unclear—even with modifications, which are likely—whether the bill will receive the necessary support to pass. The bill needs a minimum of 50 of the Senate’s 52 Republican members on board; no Democrats are expected to vote in favor of it. Additionally, the Congressional Budget Office still needs to weigh in on the financial implications of the bill.
Stay tuned for updates as they become available.
Update: On June 27, McConnell announced that a vote on the Senate bill would be delayed until after the July 4th recess.
|Jennifer Carsen, JD,is a Senior Legal Editor for BLR’s human resources and employment law publications, focusing on benefits compliance. In the past, she served as the managing editor of California Employer Resources (CER), BLR’s California-specific division, overseeing the content of CER’s print and online publications and coordinating live events and webinars for both BLR and CER.
Before joining CER in 2005, Ms. Carsen was a Legal Editor at CCH, Inc. and practiced in the Labor & Employment Department at Sidley & Austin, LLP in Chicago. She received her law degree from the New York University School of Law and her B.A. from Williams College. She is a member of the New Hampshire Bar Association.
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