Republican Senate leaders are set to release details of their sweeping health-care reform bill Thursday morning, but three new reports out Wednesday revealed details expected to be in that controversial legislation.
Those details still are subject to change, particularly because of the strict rules around the process of reconciliation that Senate Republicans hope to use to pass the bill with just 50 votes as opposed to the normal 60 they would need to overcome a Democratic filibuster.
Both Politico and Axios reported that one sticking point is how to replace Obamacare’s program of providing financial aid to help most customers pay their monthly insurance premiums with another subsidy mechanism.
A key question is whether the GOP’s bill will be able to offer financial aid for purchasing individual health plans while at the same time banning that aid from being used to buy plans that cover abortions.
Axios said Senate aides do not believe they will be able to tie that anti-abortion restriction onto the new subsidy structure, and that a backup plan is to reduce the existing amount of financial aid given Obamacare customers.
The Washington Post, in its own report, said a draft of the bill would reduce the maximum amount of money people could earn to qualify for individual plan premium subsidies from 400 percent of the federal poverty level to 350 percent. However, The Post reported that the bill would allow anyone who earns below that new level to get subsidies if they are not eligible for Medicaid, the government-run health coverage program for the poor.
Under Obamacare now, no one who earns below 100 percent of poverty can get a subsidy for a private individual health plan.
The Post also reported that the current draft would repeal all Obamacare taxes, with the exception of the “Cadillac Tax,” which imposes a surcharge on expensive health plans.
Politico reported that the Senate bill would repeal the Affordable Care Act’s requirement that most Americans have some form of health coverage or pay a fine, and another requirement that large employers offer coverage to workers or pay a penalty.
Politico also said the bill would set a four-year schedule for rolling back enhanced spending that states receive to expand their Medicaid programs under the ACA, as opposed to a three-year phase-out.
The bill would make cost-sharing subsidies that currently help low-income Obamacare customers pay for their out-of-pocket health expenses subject to an annual vote by Congress, requiring a 60-vote threshold in the Senate.
Axios’ article on the Senate bill said it probably will not include a controversial provision that had been in the House bill, which would have allowed states to obtain waivers that would let insurers not offer certain essential health benefits to customers and to let them charge sicker people higher premiums.
However, the bill also is expected to loosen restrictions on granting states so-called 1322 waivers, which would allow them to create their own sets of health-insurance rules. That loosening of 1332 rules could end up resulting in states obtaining the same sorts of waivers they would have received under the House bill.
GOP leaders in the House labored for weeks to pass their bill, and when they did so it won approval by a margin of just a single “yes” vote. That bill, known as the American Health Care Act, is broadly unpopular with the general public, and was estimated by the Congressional Budget Office to result in 23 million more people without health insurance if it became law.
Because of that, Senate GOP leaders have had the drafting of their own version of the bill done in secret, and do not plan on holding committee hearings on it, denying Democrats a chance to criticize the bill and expose possible problems with it.
The CBO is expected to issue estimates of the expected impacts of the Senate bill early next week. Republican leaders want a vote on the bill to happen in the latter part of next week, before the July 4 recess.