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You have no doubt heard that the republican leadership has released draft legislation aimed at repealing and replacing the Affordable Care Act (Obamacare), but what you may not know is that there are several other plans under consideration as well. As we continue to analyze the text of the newest republican plan, we thought you all may be interested in some of the details of these “other” plans.

The chart below shows you how three of the plans stacks up against the Affordable Care Act in ten major areas. First, the “Better Way” framework was released by House Speaker Paul Ryan in 2016 and until now represented the republican consensus. Second, the Empowering Patient’s First Act was introduced by former representative (and current Secretary of Health and Human Services), Dr. Tom Price during the 2015 legislative session. Although this plan is no longer officially under consideration, we included it as it represents the current Secretary’s views on the subject. Third, the “Obamacare Replacement Act” was introduced by Representative Rand Paul earlier this year and is generally thought to represents the more libertarian republican viewpoint. 

 

Affordable Care Act

Better Way (Ryan)

Patient’s First (Price)

Obamacare Replacement (Paul)

Exchanges

Establishes healthcare marketplaces for the purchase of individual insurance; tax credits only provided on exchange

Calls for marketplaces but does not specify that they will be run by the government; tax credits available regardless of where insurance is purchases; individual and association health pools

Does not directly address; tax credits available regardless of where insurance is purchases; individual and association health pools

Continue ACA exchanges; tax credits available regardless of where insurance is purchases; individual and association health pools

Dependent Coverage (<26)

Dependents are allowed on parent’s plans until age 26

Retain requirement

Retain requirement

Retain requirement

Guarantee Issue

Requires insurers to offer coverage regardless of health status 

Requires insurers to offer coverage regardless of health status for one-time open enrollment period; thereafter, only requires issue if continuous coverage; creates high risk pools

Requires insurers to offer coverage regardless of health status for open enrollment period every two years; thereafter, only requires issue if continuous coverage; creates high risk pools

Requires insurers to offer coverage regardless of health status only when consumer has been continuously covered for 18 months

Essential Health Benefits

Requires all plans cover a set of essential health benefits

Repeals ACA essential health benefit standard

Repeals ACA essential health benefit standard

Repeals ACA essential health benefit standard

Rating

Establishes a 3:1 rating rule; rating only for age, location and smoking status

Proposes a 5:1 rating rule; rating not allowed based on health status; does not address other factors

Repeals 3:1 rating rule; rating not allowed based on health status; rating is allowed on other factors; allows for 50% premium surcharge for non-continuous coverage

Repeals 3:1 rating rule; repeals prohibition on rating factors

Annual and Lifetime Limits

Prohibits Annual and Lifetime limits on insurance coverage

Prohibits Lifetime limits; does not address Annual limits

Repeals both Annual and Lifetime limit prohibitions

Repeals both Annual and Lifetime limit prohibitions

Medicaid Expansion

Prompts states to expand Medicaid to all consumers under 138% FPL; provides 90% of costs for newly eligible

Phase down enhanced reimbursement for newly eligible; sets further reimbursement on a per beneficiary amount

Repeals Medicaid expansion

Retains Medicaid expansion

Individual/ Employer Mandate

All individuals must have minimum essential coverage or pay a fine

Repeals requirement

Repeals requirement

Repeals requirement

Tax Credits

Advanced refundable tax credits for those under 400% FPL based on lowest priced silver plan

Advanced refundable tax credits based on consumer’s age

Advanced refundable tax credits based on consumer’s age

Retains ACA tax credits

Cost Sharing Reductions

Reduced co-pay and deductible amounts for those between 100% FPL and 250% FPL

Repeals ACA cost sharing reductions

Repeals ACA cost sharing reductions

Retains ACA cost sharing reductions

Are you wondering about the future of the Affordable Care Act? Do you find it hard to know what updates to trust? We understand!

Over the past few weeks we have started to receive more and more calls from Georgians who are concerned about the efforts under weigh on Capitol Hill to change the ACA. To keep you up to date, we have spent the past few weeks working with industry experts, health care lawyers, and the Georgia  delegation on Capitol Hill to bring you the most accurate, factual, and unbiased information available. As more plans are introduced and those in Congress begin to negotiate with each other, we will continue to bring you these updates.    

To that end we invite you to check out our new blog “Happenings on the Hill” to keep up with the latest legislative happenings.


Over the next few weeks we will be sharing details of all the plans currently being considered and discussing how these plans would change the current makeup of the ACA. We welcome dialogue, so feel free to comment on Facebook or below.