Sen. Ted Cruz, R-Texas, speaks to members of the media on Capitol Hill on July 13. Pablo Martinez Monsivais \/ AP <\/p>\n
The Senate bill would change that. It includes a modified version of a proposal by conservative Senators Ted Cruz, R-Texas, and Mike Lee, R-Utah, that would allow insurers to sell plans that do not meet Obamacares regulations. <\/p>\n
That means they dont have to not cover essential health benefits, which include everything from hospitalization to maternity care. They could also deny plans to people with pre-existing conditions or charge them more based on their health. <\/p>\n
Customers would not be able to use federal subsidies to buy these plans, which would likely have much lower premiums than other coverage, along with high deductibles. That could interest people who dont qualify for tax credits and dont have any immediate medical needs, but still want some limited insurance. <\/p>\n
If you have expensive medical needs, though, youd have to turn elsewhere. <\/p>\n
The Senate GOP bill creates a temporary $70 billion fund to help insurers pay for more expensive patients, but only if they sell comprehensive plan that contain essential health benefits and meet other Obamacare regulations. Since these plans would be far more attractive to sicker patients and the skimpier plans far more attractive to healthy people, the premiums would likely become more expensive. <\/p>\n
AHIP, the main lobby for insurance companies, has <\/p>\n
For plans that are eligible for subsidies on Obamacare's exchanges, there could be changes to \"essential health benefits\" as well. The Senate bill would allow states to waive the benefit rules in favor of their own version. In states that reduced or eliminated these benefits, healthy people could gravitate toward cheaper and less generous plans, further driving up costs for more comprehensive coverage. <\/p>\n
Treatments left out of essential health benefits could also become subject to annual or lifetime limits by insurance companies, a practice that was banned under Obamacare. <\/p>\n
This change could potentially affect benefits for employer plans as well, according to some health experts who have examined the bill. Current regulations require employers to provide coverage that's consistent with essential benefit rules in a state of their choosing. That means if one state deregulates their plans, it could give employers around the country the ability to adopt their rules and provide plans with fewer benefits and with annual and lifetime limits. <\/p>\n
The Senate bill would reduce Medicaid spending dramatically compared to current law. <\/p>\n
It would gradually eliminate Obamacares Medicaid expansion, which covers people making up to 138 percent of the federal poverty line (about $16,500 for individuals) in participating states. About 11 million people have gained coverage under this provision. <\/p>\n
Going further than rolling back Obamacare's Medicaid provisions, it would also reorganize Medicaid and cap federal spending on a per-person basis, which is a major change from the current system that matches states based on their own contribution to the program. <\/p>\n
The bill would also grow future Medicaid spending at whats expected to be a slower rate than current law, leading to deeper reductions in spending over time. <\/p>\n
The CBO found these changes, which were in the previous version of the bill, would reduce Medicaid spending by $772 billion over the next decade in comparison to current law and cover 15 million fewer people. States would have to either raise taxes or cut spending elsewhere to make up the difference or reduce benefits for Medicaid recipients like nursing home residents and people with disabilities. <\/p>\n
There are some tweaks in the new version. It includes a mechanism that would let states increase Medicaid spending if theres a health emergency that drives up per-person costs. The bill also changes a formula to help hospitals pay for low-income patients in a way that benefits states with more uninsured people, which would likely help states that chose not to expand Medicaid. <\/p>\n
The CBO and outside experts will have to weigh in on the new provisions, but theyre unlikely to offset the old version's spending reductions by large amounts. <\/p>\n
The Senate bill will eliminate Obamacares taxes on medical companies and remove its penalties on individuals who dont buy insurance and employers who dont provide it. <\/p>\n
Notably, though, it will keep taxes on high-income households that were created to finance Obamacare: A 3.8 percent tax on investment income for families making over $250,000 a year and a 0.9 percent Medicare payroll tax. The bill also keeps a tax on health insurance CEOs personal earnings. <\/p>\n
This frees up the bill to spend more elsewhere and addresses complaints by moderate Republicans over criticism that the previous version cut spending for low-income households and used the savings to lavish tax cuts on the rich. <\/p>\n
The new bill does add a tax break favored by conservatives that primarily helps higher-income families. It allows people to pay for premiums on individual insurance plans using their tax-exempt contributions to a Health Savings Account. Since lower income households usually dont have extra cash to contribute to an HSA, the change is unlikely to benefit them much. The tax benefits are also proportionally bigger for people in higher income tax brackets. <\/p>\n
A health care activist lifts signage promoting Planned Parenthood during a rally as part of the national \"March for Health\" movement in front of Trump Tower on April 1, 2017 in New York City. Kevin Hagen \/ Getty Images <\/p>\n
The bill would cut off Planned Parenthood from receiving Medicaid payments. The organization is already barred from accepting federal contributions for abortion, but is reimbursed by the government for other treatments. <\/p>\n
Insurers would also not be allowed to offer individual plans eligible for subsidies that cover abortion. Under Obamacare, insurers can include abortion coverage, but the provision is paid for separately using premiums and not federal subsidies. <\/p>\n
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Major Health Care Changes in the Senate GOP Bill - NBCNews.com<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Sen. Ted Cruz, R-Texas, speaks to members of the media on Capitol Hill on July 13. Pablo Martinez Monsivais \/ AP The Senate bill would change that Continue reading