Updated at 12:16 p.m. ET
Senate Republicans unveiled their long-awaited health care overhaul proposal on Thursday. The Senate bill, called the “Better Care Reconciliation Act,” would repeal major parts of the Affordable Care Act, also known as Obamacare. The broad outlines of it look a lot like the House bill, the American Health Care Act, which was passed in May.
In a lot of ways, the Senate’s bill looks like the House bill: it rolls back the ACA’s Medicaid expansion — making for deep spending cuts to that program, compared to current law. The Senate bill also proposes eliminating many ACA taxes. As in the House bill, the employer penalties associated with the employer mandate would be repealed retroactively, dating back to the start of 2016. And young adults up to the age of 26 could stay on their parents’ health care plans.
Larry Levitt, a health policy expert at the Kaiser Family Foundation, summed up his thoughts on the bill on Twitter on Thursday: “In broad strokes, the Senate bill is just like the House: Big tax cuts, big cut in federal heath spending, big increase in the uninsured.”
A small group of Republican senators has written the bill in secret in recent weeks, with many Americans and even some fellow Republicans eagerly awaiting details about what’s in the bill. After the bill was released on Thursday, protesters gathered outside Senate Majority Leader Mitch McConnell’s office. Video from NBC showed police removing some of those protesters from the hallway.
JUST IN: Police carry protesters from Sen. McConnell’s office after Republicans unveil draft of health care bill. https://t.co/MxcxW2cN62
— NBC Nightly News (@NBCNightlyNews) June 22, 2017
There are a few other ways the Senate bill mirrors the House bill. In addition, it bans the use of any federal funds for any health care plan that covers abortion, except in the cases of rape, incest or where the pregnancy puts the mother’s life in danger.
As of 2020, the bill also eliminates cost-sharing subsidies that help low-income Americans pay for their insurance.
But it also has some key differences from the House bill. For example, it cuts the upper-income limit that determines who gets premium tax credits. Currently, that upper limit is at 400 percent of the poverty level. This bill would limit that to 350 percent.
Like the House bill, the Senate bill would also drastically change Medicaid, the program that provides health care to lower-income Americans, but with some key differences. The Affordable Care Act greatly expanded Medicaid, extending it to some low-income Americans above the poverty level. The Senate proposal would roll back that expansion, though it would do so more slowly than the House bill proposes.
As with the House, the Senate proposes giving states either a per capita cap on Medicaid spending or a block grant of funds. However, the inflation rate the Senate would attach to those caps would be lower than the inflation rate the House attached — the ultimate result being less Medicaid spending, as health policy expert Nicholas Bagley pointed out on Twitter on Thursday.
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