Republican senators released a revised version of a bill to repeal and replace the Affordable Care Act Thursday, which contains more flexibility for insurers, new funding to combat the opioid crisis and leaves some of the ObamaCare taxes intact.
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While Republicans cheered the initial bill’s elimination of the ACA-related taxes, critics claimed the GOP was using health care as a backdoor tax cut for the wealthy. In the new draft, the 3.8% net investment income tax and the 0.9% payroll tax to help fund Medicare will remain— these taxes apply to individuals with incomes in excess of $200,000 and couples filing jointly with incomes in excess of $250,000. Some Republicans have suggested those taxes could be tackled during the health care reform debate.
The bill will also keep the limit on executive pay in the health care industry as mandated under the Affordable Care Act.
Sen. Ted Cruz’s (R-Texas) Consumer Freedom Amendment has been added to the bill, which allows insurers to offer plans that do not comply with ObamaCare requirements so long as they simultaneously leave existing plans on the individual market. This essentially allows insurance companies to offer cheaper plans that don’t have all the bells and whistles necessitated under the Affordable Care Act. It also allows individuals to use health savings accounts to pay for premiums.
The new draft recommends providing $45 billion to combat the country’s growing opioid epidemic. The GOP also proposes allocating an additional $70 billion for state-based reforms, which could include strategies to cut premium costs; in total the bill includes $170 billion for these efforts.
Notably, the bill doesn’t significantly alter plans to gradually slow the expansions of Medicaid. That was a big criticism of the first bill, with some groups asserting it would hurt America’s most vulnerable populations. Many of the other provisions, including coverage for preexisting conditions and the elimination of the employer and individual mandates, have been kept the same.
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There is at least one Republican senator who has already said he is opposed to the new bill. Sen. Rand Paul (R-Ky.) told FOX Business Thursday he did not support the stabilization fund for insurance companies.
“I’m not willing to subsidize insurance companies. I think that’s a terrible thing to do,” he said. “It’s crony capitalism and there has to be somebody left in Washington who doesn’t believe in crony capitalism.”
The CBO is expected to release a score for the revised bill as soon as Monday and the bill could be put up for a vote as early as the latter part of next week.