No, this isn't a reference to Hollywood's reboot of Stephen King's scary movie about a clown. Instead, what's now back on the table is another Republican attempt to replace Obamacare. Republican senators Bill Cassidy, Lindsey Graham, Dean Heller, and Ron Johnson are promoting a new healthcare bill that makes significant changes. Here are seven ways this last-ditch plan to replace Obamacare could affect you.
1. No more individual mandate
As with previous GOP attempts to dismantle Obamacare, the latest bill repeals the mandate that all Americans obtain health insurance coverage or pay a penalty. This means that, if the bill ultimately becomes law, if you choose to go without health insurance, it won't cost you at tax time. However, the legislation would allow health insurers to charge 30% more for individuals who obtain coverage without maintaining previous continuous coverage during the previous 12 months.
2. No more employer mandate
Also gone is Obamacare's mandate that employers with 50 or more full-time employees provide health insurance coverage to their employees. This particular provision of Obamacare has been delayed twice from being implemented, so it won't mean a real change to anyone. However, because it is still part of the law, it would mean that some Americans could obtain employer coverage unless the provision is changed (as the latest GOP bill does) or delayed yet again.
3. A new way for small employers and self-employed to get coverage
The bill would allow smaller employers and self-employed individuals to participate in "small business health plans" that can obtain similar health insurance coverage to what large employers can get. If you're employed by a small organization or are self-employed, you could benefit from lower premiums.
4. Lower taxes -- barely
Many of the tax increases included in Obamacare would stay in place with the new proposal to avoid adding to the federal deficit. One major tax, however, that would be repealed is the 2.3% medical-device excise tax.
5. Health savings accounts (HSAs)
Similar to previous GOP efforts, the latest bill promotes HSAs. It would increase the maximum contribution limit to HSAs to match out-of-pocket limits. It would also allow spouses to make catch-up payments to the same HSA.
6. Significant changes if you're on Medicaid
Perhaps the most significant Medicaid-related change in the legislation is that it ends the Obamacare provision under which the federal government subsidized states that chose to allow individuals making more than the poverty level to participate in Medicaid. In place of these subsidies for Medicaid expansion, the bill would give states block grants to essentially create their own healthcare systems. The bill would also allow states to check Medicaid eligibility requirements more often and implement work requirements for many healthy adult Medicaid recipients.
7. Possibly lower individual health insurance premiums
Probably the biggest question Americans with individual health insurance will ask is: Will the proposed legislation reduce my soaring health insurance premiums? The answer to that question is maybe. It's possible that states could make innovations using the block grants that reduce individual premiums. In addition, states could obtain waivers under the proposed bill to change the essential health benefits included in Obamacare. Such changes could lead to lower-cost health plans.
What won't change
A lot of Obamacare won't change at all under the latest GOP plan. Insurers must cover pre-existing conditions. Dependents up to age 26 can stay on their parents' health plans. The Obamacare exchanges will stay in place. As mentioned, many of the taxes in Obamacare will remain.
Also what probably won't change is the difficulty in getting the proposed legislation passed. Senator Cassidy thinks the bill has the support of 48 or 49 Republicans. Fifty votes are needed to allow Vice President Mike Pence to cast a tie-breaking vote for the bill to pass in the Senate. And the clock is ticking: Less than two weeks remain for the legislation to be passed under a reconciliation process that prevents filibustering.
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