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Your Consumer Guide to the Senate Health Care Bill: 7 Key Points to Consider

Democrats ready? Republicans ready? Hospitals ready? Doctors ready? Cable news experts ready? Not sure, but what we really care about is whether you – the consumer – are ready for the national debate about the repeal and replacement of the Affordable Care Act, also known as Obamacare. Here are seven things to watch for as the Senate considers passing their bill by July 4th.

1 • New Name, Similar Provisions

The name of the Senate’s bill is THE BETTER CARE RECONCILIATION ACT. The House bill is named THE AMERICAN HEALTH CARE ACT. The provisions between the Senate bill and the House bill are similar. While some provisions are better for the consumer – some are worse. Read on for details.

2 • Medicaid Cuts

Medicaid is a state program that covers the poor and disabled, including nursing home residents. According to the Kaiser Foundation, Medicaid currently covers:

  • 20% of all Americans
  • 64% of all nursing home residents
  • and 60% of all children with disabilities

The Senate bill would reduce federal spending on Medicaid by more than $800 billion. States will receive less money; and the fear is they will be forced to:

a. Raise money from other sources to provide the same services; or

b. Provide less services to the most vulnerable Americans.

Ask yourself, What is their plan for covering these vulnerable Americans?

3 • Tax Cuts

Taxes will be cut to the wealthy. While there doesn’t seem to be much debate about this (as it is in both House and Senate bills), it is considered by many to be very troubling, considering what is happening to Medicaid.

4 • Pre-Existing Conditions/Essential Health Benefits/State Waivers

Right now, the following are all guaranteed under the current Affordable Care Act:

  • Protection against being dropped from coverage because of a pre-existing condition
  • Being assured of a core set of benefits, including mental health and maternity coverage
  • Protecting seniors from being charged more than three times what a healthy person is charged.  

The Senate bill, like the House bill, allows states to seek waivers from these provisions. In fact, under the Senate bill, the ability of states to seek waivers seem easier to achieve than the House bill. This could result in higher premiums for people with pre-existing conditions or insurance policies that don’t cover certain benefits such as mental health and maternity.

5 • No More Penalty Provisions or Employer Mandate

As with the House bill, under the Senate bill you would not be required to obtain insurance and you would not have to pay a penalty if you don't have insurance.

6 • Subsidies

Subsidy assistance is available to help people pay for insurance, but the Senate bill ties subsidies to income levels rather than age. This means that a person with a lower income could receive more help with their premiums than another person whose income level is higher.

7 • Votes Needed

50 votes are needed to pass the Senate bill. If there is a tie (50 to 50), it is expected that Vice-President Pence will vote in favor of the Bill.

What if the Senate bill passes? If the Senate bill passes, then representatives of the House and Senate will meet to work through the differences between the two bills. If a compromise is reached that is acceptable to both the Senate and House, then the compromise bill would go to the President for his signature. Once signed, the bill will become law. This could become law as soon as this fall, after Congress takes its summer recess.

Stay in the Know. We will continue to keep an eye on what’s happening with this and explain what it could mean for you, so stay tuned!


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