Senate Health Reform Bill Changing By the Day

Last week, it appeared the Senate Republicans may be able to get a bill to the floor for consideration this week. As of July 14, two Republican senators rejected the party’s latest health-care bill, leaving the party no margin for additional defections if Senate Republicans hope to get a bill to the floor.

But this week it is truly access to health care services that is stopping the debate: Senator John McCain’s access to health care as he undergoes eye surgery to address a blood clot above his left eye.As we await the Senate’s consideration of its health reform bill there is always the potential for further negotiation and change to the underlying bill.

Several modifications were made to the original Senate plan last week. They include the following:

  • $70 billion added to stabilize insurance exchanges on top of $112 billion for the same purpose in an earlier measure.
  • Discard earlier plans to repeal three Obamacare taxes on the wealthy that would add up $230 billion to cover health expenditures.
  • Health savings accounts would be allowed to pay insurance premiums.
  • Would allow people earning up to 350 percent of the poverty level to receive subsidies.
  • Would also allow people to purchase a high-deductible catastrophic-coverage plan with federal tax credits.
  • Prohibits plans eligible for tax credits from providing abortion coverage except in cases of rape or incest, or to save the life of the mother.
  • Includes a federal fund that would pay health insurers to cover costs of sicker people seeking individual coverage on the insurance exchanges. Insurers would have to meet minimum coverage standards in the exchange, while also offering coverage off the exchange that meets state requirements. Those buying state-governed plans would not be allowed to use federal tax credits to buy their coverage but could tap tax-advantaged health savings accounts to cover the costs.
  • For high cost states like Alaska, one percent of expanded state innovation and stability grants would be reserved specifically to subsidize insurance in states where premiums are at least 75 percent higher than the national average. Starting in 2022, states would have to share in the costs of those funds with their own money, with states having to shoulder 35 percent of the burden in 2026.
  • The bill changes the calculation for determining Medicaid payments to hospitals to assist with uncompensated care that is expected to more accurately allot the funds based on a state’s uninsured population instead of Medicaid enrollment as the original legislation did.
  • Allows insurers to offer cheap, bare-bones plans alongside those that meet the more comprehensive coverage requirements of Obamacare.