- The bill would utterly eviscerate Medicaid, which is relied on by tens of millions of poor, elderly and disabled Americans. It would roll back the Affordable Care Act’s expansion of Medicaid and cut hundreds of billions of dollars from the program. It would also transform the program into a block grant, for the first time allowing states to kick enrollees off their coverage and cut back benefits.
- The bill allows insurers to sell bare-bones plans that go by the name “insurance” but cover very little, as long as they also offer a plan that meets the “essential health benefits” requirement of the ACA. This in effect sets up two pools, one containing young and healthy people, and one containing people who are older or who have more serious health needs. The insurance industry, along with many analysts, predict that this could produce a death spiral of skyrocketing costs for those with preexisting conditions.
- The bill retains the ACA’s 3.9 percent tax on investment income and 0.9 percent payroll tax for wealthier Americans.
- It eliminates the ACA’s cost-sharing subsidies after two years, but creates a fund with $182 billion (over 10 years) for states to use to help patients with out-of-pocket costs and those with high medical expenses.
- It allows people with tax-preferred Health Savings Accounts to use their HSAs to pay premiums, which they are currently not allowed to do. Note that HSAs overwhelmingly benefit wealthier people, because they’re the ones with spare money they can put into them to gain the tax benefits.
- Though it slashes the Medicaid through which many opioid addicts now receive treatment, it sets aside $45 billion to combat opioid addiction.
- It has a new provision allowing people to use tax credits to buy catastrophic plans with extremely high deductibles that cover no routine care.
- It replaces the ACA’s subsidies with stingier tax credits based on what high-deductible plans cost and allows insurers to charge older people more than they can now.
- As before, it eliminates the individual and employer mandates, bars tax credits from being used for any insurance plan that covers abortion and prohibits women on Medicaid from getting any treatment at Planned Parenthood facilities.
July 13, 2017 at 1:06 PM EDT