Comparison Between HOUSE and SENATE Healtchare Bills

I thought it was time for a comparison between the Senate and House healthcare bills and the affordable care act.
My trade organization, the National Association of Health Underwriters (NAHU) is a national organization made up of insurance professionals from all 50 states. We are well organized nationally, regionally and locally.
As a past President of the Clark County Association of Health Underwriters and currently the state and local Medicare chair, I have access to a comparison crafted by NAHU to show the differences between both bills and the affordable care act.
The comparison clearly shows the differences in each facet of the bill.

 

INDIVIDUAL MANDATE

Affordable Care Act To help reduce the risk of adverse selection and make the guaranteed issue provision work, most people are required to have health insurance or pay a penalty.
American Health Care Act Reduces the individual mandate penalty to $0. Adds a12-month, 30% surcharge for people who purchase coverage after a gap of 63 days or more.
Better Care Reconciliation Act Reduces the individual mandate penalty to $0. No surcharge for late enrollees.  Upon enrollment in a new policy, those who had a gap in creditable coverage of more than 63 days in the previous 12 months will be subject to a 6 month waiting period.

EMPLOYER MANDATE

Affordable Care Act Requires employers with 50 or more full-time equivalents to offer affordable, minimum value coverage or pay a penalty.
American Health Care Act Reduces employer mandate penalty to $0.
Better Care Reconciliation Act Reduces employer mandate penalty to $0.

TAX CREDITS

Affordable Care Act Offers advance premium tax credits to people with incomes up to 400% of the federal poverty level who do not have access to minimum essential coverage and who purchase coverage through a federal or state Marketplace.
American Health Care Act Phases out the premium tax credits and replaces them with age-adjusted tax credits ranging from $2,000 for people in their 20s to $4,000 for people in their 60s.
Better Care Reconciliation Act Reduces eligibility for premium tax credits to 350% of the federal poverty level and ties tax credit calculation to a bronze level (58% actuarial value) plan rather than a silver level (70% actuarial value) plan.

SUBSIDIES

Affordable Care Act Reduces out of pocket expenses for people with incomes up to 250% of the federal poverty level who purchase a silver-level plan through the Marketplace.
American Health Care Act Phases out the cost-sharing subsidies. Creates state innovation grants that can be used, in part, to reduce out-of-pocket expenses.
Better Care Reconciliation Act Phases out the cost-sharing subsidies. Creates state innovation grants that can be used, in part, to reduce out-of-pocket expenses.

ESSENTIAL BENEFITS

Affordable Care Act Requires individual and small group health plans to cover 10 categories of essential health benefits (plus additional essential benefits defined by the states).
American Health Care Act States can apply for waivers that allow them to eliminate essential health benefits requirements.
Better Care Reconciliation Act States can apply for waivers that allow them to eliminate essential health benefits requirements.

PRE-EXISTING CONDITIONS

Affordable Care Act Prohibits insurers from denying coverage or charging more for people with pre-existing conditions.
American Health Care Act Allows states to set up risk pools for high-risk individuals and to permit insurers to charge more for pre-existing conditions in certain circumstances.
Better Care Reconciliation Act Prohibits insurers from denying coverage or charging more for people with pre-existing conditions.

AGE RATING

Affordable Care Act On individual and small group plans, limits age rating to a 3 to 1 basis (insurers can charge older people up to 3 times as much as young people).
American Health Care Act Expands allowable age rating to 5 to 1 (insurers can charge older people up to 5 times as much as young people).
Better Care Reconciliation Act Expands allowable age rating to 5 to 1 (insurers can charge older people up to 5 times as much as young people).

MEDICAID

Affordable Care Act Allows states to expand Medicaid to 133% of the federal poverty level and include healthy adults. The federal government pays for the majority of the expansion.
American Health Care Act Ends expanded Medicaid and creates block grants for states.
Better Care Reconciliation Act Ends expanded Medicaid and creates block grants for states. The Medicaid cuts are bigger than the House bill but are phased in over a longer period of time.

TAXES

Affordable Care Act To pay for the tax credits, subsidies, and expanded Medicaid, the ACA created more than a dozen new taxes, including taxes on insurers, pharmaceutical companies, and high income individuals.
American Health Care Act Eliminates most ACA taxes and delays the Cadillac tax by several years.
Better Care Reconciliation Act Eliminates most ACA taxes and delays the Cadillac tax by several years.

Len Barend, Broker
The Barend Agency Inc.

www.insurance4unevada.com

702-250-2200

len@insurance4unevada.com

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