Human Resources News & Insights

Senate’s new ACA repeal bill: What’s different from the House version?

Want to discuss the Senate’s new “discussion draft” of its ACA repeal bill with upper management but don’t have time to sift through the 142-page document? We’ve got you covered.

The “Better Care Reconciliation Act of 2017,” the Senate’s version of an ACA repeal and replace bill is slated to go to vote as early as this week.

From an employer perspective, the Senate bill is very similar — and in many cases identical — to the version the House successfully voted to pass recently. It includes the end of the employer mandate, a delay of the Cadillac Tax until 2027 and an increase to HSA contribution amounts (a carryover from the house bill).

And while there is certainly a lot to unpack in this sizeable legislation, employers should keep this point top of mind: There’s a very good chance changes will be made before this bill is brought to a vote in the Senate.

Reason: At least three Senators have hinted that they plan to oppose the legislation, and the bill can only afford to lose two votes to pass.

Key differences

Instead of going through everything in the Senate bill that’s similar or identical to the House bill, here’s a look at the key differences:

Income-based subsidies return. Healthcare subsidies are tied to income in the Senate Bill — like in the ACA. In the House version of the bill, health care subsidies were tied to age, so the older a person is, the more assistance he or she would receive in paying for health insurance. In the Senate version of the bill, subsidies would be tied to income, like they are in the ACA (the House bill tied subsidies to age).

However, the Senate version of the bill would tighten the eligibility criteria starting in 2020.

No pre-existing condition opt-outs. The Senate also balked at the House bill’s provision that would allow states to opt out of requiring plans to provide equal access to those with pre-existing conditions.

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