Senate GOP leaders on Thursday finally released their secret health-care reform bill, which would repeal Obamacare taxes, restructures subsidies to insurance customers that are based on their incomes, and phase out Medicaid’s expansion program.
Republicans plan to bring the controversial bill to a quick vote next week, but face potentially fatal opposition to it from several members of their own caucus.
The bill, if passed into law, would sharply reduce financial aid that currently helps millions of people obtain health coverage, while at the same time offering a tax break to primarily wealthy Americans.
The bill would repeal, retroactive to the beginning of 2016, the Obamacare rule requiring most Americans to have some form of health-coverage or pay a tax penalty fine. That repeal is expected to increase the number of people who don’t have insurance, which could in turn lead insurers to raise premiums.
And it would repeal, retroactively to the beginning of 2016, the “employer mandate,” which requires large employers to offer health insurance to workers or be fined.
The bill also would continue for at least two years to offer reimbursements to health insurance companies for subsidies that reduce out-of-pocket costs for low income customers of Obamacare plans. But those subsidies would end in 2020, which would increase deductibles and other out-of-pocket health expenses for millions of customers.
The federal government’s share of funding for Medicaid, which is jointly run with individual states, would fall over the course of seven years to end up at around 57 percent of the cost of that program, which offers health coverage to the poor.
Under Obamacare, the federal government had guaranteed that its funding for adults newly eligible for Medicaid because of the Affordable Care Act would fall to no lower than 90 percent of their costs.
In another cost-cutting move, the bill would lower the maximum income level a household could have to still qualify for federal subsidies that help reduce the premiums people pay for enrollment for individual health plans. Obamacare bar subsidies to families that earn more than 400 percent of the federal poverty level. The new bill would reduce that cap to 350 percent of the poverty level.
Younger people, as a group, would end up paying less of a share of their income toward their individual health plans under the bill in comparison to what they pay now under Obamacare, while older people as a group would end up paying a larger share of their income.
Health plans that offer abortion services would not be eligible for the subsidies, according to the draft released Thursday.
The federal government also would end up spending less money subsidizing people’s insurance purposes by changing how the value of those subsidies are calculated. The bill would use a less-expensive type of individual health plan to calculate those subsidies, as opposed to the pricier plan used under Obamacare.
The bill also seeks to repeal, to the start of 2017, the 3.8 percent tax on net investment income.
The Trump administration is expected to back the bill, which most GOP senators were learning the details of during a meeting Thursday morning. The bill is named the “Better Care Reconciliation Act of 2017.”
The House’s version of the bill, dubbed the American Health Care Act, is broadly unpopular among the public, and had been reportedly called “mean, mean, mean,” by President Donald Trump during a meeting with senators.
“In broad strokes, the Senate bill is just like the House: Big tax cuts, big cut in federal heath spending, big increase in the uninsured,” tweeted Larry Levitt, an Obamacare expert at the Kaiser Family Foundation.
“Under the Senate bill, low-income people would pay higher premiums for bigger deductibles,” Levitt said.
Senate GOP leaders want to have a vote on the bill by late next week, before Congress’ Fourth of July recess. They do not plan to hold any hearings on the legislation, infuriating Democrats, who were frozen out of the drafting process.
To pass, Republicans must get at least 50 GOP senators to vote for the bill, since no Democrat or independent is expected to vote for it. Vice President Mike Pence would break any tie, and would be expected to vote for the bill. There are 52 Republican senators.
On Thursday, about an hour after the bill was posted online, NBC’s Chuck Todd tweeted that there are at least three Republican senators, and possibly more, who plan to announce later today that they will oppose the bill.
If that number proves to be accurate, it could be a death blow to the bill.
