The first version didn’t have enough support in the Senate, so it was back to the drawing board. Now we have a new bill—but will this one get the necessary votes? Senators Susan Collins (R-Maine) and Rand Paul (R-Ky) have already said it doesn’t do enough. Can it squeak through the Senate? Let’s look at some of these changes, and a possible alternative:
The biggest change, designed to sway conservative votes, was pushed by Ted Cruz (R-Tex.). It allows insurance companies to offer catastrophic plans, thereby circumventing the ACA’s “minimum essential benefits” rule. These plans would charge sicker people more than healthy people and permit individuals to select only the benefits they need, as long as the insurance companies offer at least one plan that complies with the ACA standard.
The bill also allocates an additional $45 billion to combat the opioid crisis which has hit some states especially hard. Senators Shelley Moore Capito (R-W. Va.) and Rob Portman (R-Ohio) indicated that the lack of funding for this crisis was a key reason that they objected to the original Better Care Reconciliation Act (BCRA). Whether this will provision will be adequate to secure their votes remains to be seen.
The future would brighten significantly for Health Savings Account (HSA) owners. Not only would there be an increase in the contribution limits, but these accounts could also be used to pay health insurance premiums. The idea is to encourage more people to fund HSAs by expanding the benefits of these accounts.
What if this bill doesn’t pass? Enter Lindsay Graham (R-S.C.) and a newer compromise version of the BCRA. The idea behind this version of the bill is to appeal to Republicans as a replacement plan and to sell it to Democrats as a repair plan. It would keep all of Obamacare’s taxes except for the Medical device tax, and would allocate $110 billion in federal health care funding to states. Also included is an ending to the individual and employer mandates, however it retains protection for people with pre-existing conditions. The bill will most likely be offered as an amendment to the second version of the Senate bill.
These days, it’s hard to follow health care. Let’s hope it gets easier soon.