Senate Releases Draft Health Care Bill

On Thursday the Senate released a "Discussion Draft" of the Better Care Reconciliation Act (BCRA).  To view the draft you can click here.  At this point the bill is still open for amendments and awaiting a CBO score at the beginning of next week. This means that what is in the existing draft bill will most likely change prior to what is expected to be a vote before the Senate leaves for the July 4th recess next week.

As currently written there are many similarities with the AHCA which was passed last month by the House, but there are some differences as well. (To see our review of the house bill you can click here).

The major differences from the AHCA in this draft bill are:

-No version of an individual mandate (the AHCA would allow insurers to apply a 30% surcharge to premium if an insured had a certain gap in coverage). 

-The pull back of funding for Medicaid expansion is drawn out a little longer, but it appears that the long term funding for Medicaid will be lower than the AHCA proposed.

-The tax credits would be different, capping out at 350% of the poverty level and being tied to a 58% actuarial value plan (the ACA credits were tied to a 70% plan and the AHCA were only age based).  The BCRA does seem to correct the coverage glitch for non-Medicaid expansion states that will allow those at the low end of the poverty level not currently eligible for either Medicaid or a subsidy in the exchange to receive some assistance.

As with the AHCA there are really no adverse impacts to employer-sponsored plans.  The employer mandate would go away which would remove the requirements to offer coverage to all employees averaging more than 30 hours a week. There are enhancements to HSAs which would be favorable to those employers who offer HDHP plans and their employees are eligible for HSAs.  The ACA premium subsidies would stay in place in 2018 and 2019 so many of the existing reporting requirements would most likely stay in place, at least in some capacity.  Moving forward subsidies would continue to be contingent on not having an offer of employer sponsored coverage, so some reporting requirements will most likely remain long term.

Once the bill is finalized and we are confident about the content we will provide some additional updates in the form of blog posts and a webinar.  Stay tuned.