Comparison of Better Care Reconciliation Act, American Health Care Act and Affordable Care Act – Obamacare

With so much happening in regards to health reform efforts, it’s vital that employers pay attention to the latest changes and proposals.  The Senate’s version of health care legislation designed to replace ObamaCare, called the “Better Care Reconciliation Act of 2017” has stalled without the necessary votes to pass.  A revised version of the bill is due out soon with the plan to proceed quickly to vote.    The current Senate plan does vary somewhat from the House’s already passed bill.  Read on for some key differences between the plans including a CHART highlighting key provisions and differences between The Affordable Care Act (Obamacare), The House American Healthcare Act  and The Senate Better Care Reconciliation Act.

SOURCE: NPR

 Highlights of the “Better Care Reconciliation Act of 2017”

Coverage

The Senate health care legislation is expected to provide coverage for 4 to 5 million additional people, according to an analysis from the health care advocacy group the Council for Affordable Health Coverage.  They also predicted that premium increases expected with the House bill would be scaled back.

Tax credits

The Senate’s health care legislation would give tax credits based on age, income and geography — to a certain extent — like the Affordable Care Act already does.  Tax credits under the House plan would primarily only be based on age.

More flexibility on insurance regulations

The bill doesn’t include the controversial House waivers letting states charge consumers more based on health status and lifting a requirement to cover certain health services. But it bolsters waivers created under the Affordable Care Act that gives states creative ways to implement ObamaCare. The new powers give the states more flexibility to use waivers to decide the rules of insurance for their state. Senior GOP Senate aides say the waivers can be used to waive essential health benefits. But in a departure from the House bill, states can’t opt of regulations governing pre-existing conditions.

Changes the age rating to 5:1

That means insurers can charge older adults five times as much as younger people. ObamaCare only lets insurers charge older people three times as much.

Repeals all of ObamaCare’s taxes

The only tax kept is the Cadillac tax, a fee levied on high cost employer insurance plans, though it would be delayed until 2026.

Individual mandate

Under the Senate bill, the individual mandate — an Obamacare tax penalty imposed on those who don’t purchase health insurance — would be eliminated.  The House legislation also does away with the individual mandate, but it does allow for insurance companies to impose a surcharge on those who purchase a new plan after letting their previous coverage lapse. While insurers would be able to impose up to a 30 percent surcharge, states would have the option to make the penalty harsher.

Opioid epidemic

The Senate legislation creates a $2 billion fund to provide grants to states for substance abuse and mental health treatment.  The House did not include such an allocation.  Under ObamaCare, Medicaid expansion has enabled many states to provide comprehensive treatment to people caught in the opioid epidemic.

Medicaid

The Senate’s “Better Care Reconciliation Act of 2017,” stretches the phase-out of Medicaid expansion financing and higher payments would be provided through 2023.  The bill uses a less generous inflation adjustment than the House bill. But Medicaid cuts would be greater with this legislation than under the House bill.

Under the House bill, the federal government’s monetary match for expanded Medicaid would be reduced beginning in 2020. The program would also no longer be an open-ended entitlement.


Stay tuned for updates and changes.  Remember, for now, Obamacare is still the law of the land and employers should follow all outlined requirements and deadlines.  If you have any questions regarding Obamacare compliance or health insurance benefits for your employees or yourself, please contact your W&D advisor at (847) 267-9600.

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