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Health Insurance Print

More Fireworks to Come on Senate Health Care Bill

Expect more fireworks next week on the Senate’s attempt to repeal and/or replace the Affordable Care Act when Congress returns next week from their 4th of July recess. 

Here is what we think you can expect in the weeks to come:

1 • Pressure to Pass a Bill

Whether this pressure comes from the White House or is self-imposed, the Senate will have a sense of urgency to pass something sooner rather than later.

2  • Listening to Their Constituents?

According to a variety of media reports, many Senators got an earful from voters on how bad they think the Senate bill is and how many people will be adversely impacted. Whether these complaints will affect their actions remain to be seen.

3 • Primary Areas of Focus

The two areas that seem to be getting the most publicity (most of it bad) are:  

  • Cutting Medicaid funding combined with removing taxes on the wealthy.
  • Solving the pre-existing condition problem is also a major area of concern.

4 • Cruz Plan for Two Options

Over the last couple of days, Senator Ted Cruz has circulated an idea that seems to gaining some traction among the conservative and moderate groups. His idea is to allow insurers to offer two plans:  

  • An Obamacare insurance plan (with all of the current requirements and benefits); and
  • A non-Obamacare insurance plan (without all of the current requirements and benefits). This non-Obamacare plan might provide fewer benefits at a lower price.

If you have a pre-existing condition or are a high-risk patient you will likely gravitate to the Obamacare plan. If your income is low enough, you would qualify for a subsidy. So the Obamacare insurance plan will be for less healthy people and the non-Obamacare Plan will be for healthier people.

So who benefits by this? Well, if you are healthy or you don’t want all of the coverage bells and whistles, you will be able to buy insurance for relatively low cost.

If you are not healthy and your income is low enough, you will be able to keep your Obamacare insurance plan and, although the premiums will be high, the government will subsidize your premium payments.

So what could be the downside? Well, if you are a high-risk patient with an income above the subsidy level (about $47,000 per year for a single person), and you want to participate in the Obamacare insurance plan, it is possible that your insurance premium will be so high that it will be unaffordable to many people. Remember, this group of people will likely not be as healthy as those who opt for the other plan.

5 • Timing

Watch for lots of action during the first week or two that Congress returns.  While passage is unlikely the first week back, things may pick up steam soon after.

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