Despite suffering from a past heart attack and diabetes, Kentucky resident Mary Blair was able to receive medical coverage through Medicaid expansion under the Affordable Care Act.

Luke Sharrett | The Washington Post | Getty Images

Despite suffering from a past heart attack and diabetes, Kentucky resident Mary Blair was able to receive medical coverage through Medicaid expansion under the Affordable Care Act.

“This bill, ultimately at the end of the day, will result in tens of millions of Americans who will not have health insurance,” said Starc.

Yet, the changes to funding for the individual market in the Senate bill could change the picture when it comes to enrollment on the exchanges.

The Senate bill maintains Obamacare’s income-based tax credits, cutting eligibility for some middle-class enrollees at 350 percent of the federal poverty level — which is just over $41,500 this year. At the same time, it would extend them to lower-income Americans, who earn less than $11,000 a year, who under the ACA would only gain coverage under the Medicaid Expansion plan.

But the Senate bill repeals the employer and individual mandate, along with penalties, which could have a negative effect on premium prices.

“The elimination of the individual mandate will create the potential for anti-selection in the individual market,” said Rebecca Owen, health research actuary with the Society of Actuaries, adding “actuaries will be watching this closely to determine the financial impact, as well as the implications for overall medical risk in the marketplace.”

The actuaries point out the CBO score on the Senate bill will key, before a vote. And if the legislation is passed, it still faces another vote in the House.

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