Senate Delays Vote on Health Care Reform Legislation

On Tuesday, June 27, Senate Republican leadership decided to delay a vote on the Better Care Reconciliation Act, a substitute for the House-passed American Health Care Act (AHCA).  A vote was previously scheduled for this week but was delayed after several Republicans raised concerns with the legislation, threatening its success of passage.

This legislation, which includes revisions released on Monday, June 26, would repeal the penalty for individual and employer mandate.  It also maintains the Affordable Care Act’s income-based premium tax credit subsidy with modifications effective in 2020.  This is a change from the House-passed bill which created age-based subsidies.  The Senate bill also provides tax-credit eligibility to individuals from 0% to 350% of the Federal Poverty Line (FPL) and enhances tax-credits for younger individuals.

The Senate bill also expands the Affordable Care Act’s section 1332 waiver program to allow states significant flexibility in setting essential health benefits, cost-sharing and other health plan requirements.  The bill provides $112 billion to fund state innovation activities through the State Stability and Innovation Program.   For Medicaid, the Senate bill would phase out the Medicaid enhanced expansion funding match between 2021 and 2024, and change Medicaid to a per capita cap system effective in 2020.  The bill also provides cost-sharing reduction (CSR) subsidies for 2018 and 2019 and then ends program. 

Also on Monday, the Congressional Budget Office (CBO) and Joint Committee on Taxation released its score of the bill, which indicated that enacting the legislation would result in an estimated 15 million more people that would be uninsured in 2018 compared to the number of uninsured now, and by 2026, 22 million more would be uninsured. 

For the Senate bill to pass, no more than two Republicans can oppose the legislation. As an increasing number of Republicans voiced concerns over the bill and its process, Republican leaders decided to postpone the vote so further changes could be made.

A full ASA summary of the legislation and CBO score can be found online at www.asahq.org/heatlhcarereform.

ASA leadership and staff continue to monitor development of health care reform legislation, and will provide updates as they become available.