ObamaCare Repeal Act (HR 175) Overview

[TechWriter]

For those of you thinking of full timing, under 65, and who must purchase their own health insurance, here's a summary of the latest House health care bill.

This just summarizes the House bill (HR 175). The bill goes to the Senate next. Here's a description of the upcoming legislative process.

ObamaCare Repeal Act (HR 175) Details, Here’s the full text of the bill.

Individual Mandate
ACA: Penalty if you don’t purchase health insurance.
HR 175: No penalty. However, insurance premiums can be 30% higher if “continuous coverage” (under 63 days of lapsed coverage) is not maintained.

Essential Health Benefits:
ACA: See Essential Benefits.
HR 175: The same as ACA.

Subsidies (ACA/HR 175 comparisons)
ACA: Sliding scale based on income.
HR 175:
Credits are capped at $14,000 per family. The following structure would begin in 2020 with modifications in 2018 and 2019 to give more to younger people and less to older folks:

Under 30 = $2000
Under 40 = $2500
Under 50 = $3000
Under 60 = $3500
60 and older = $4000

HSA Accounts:
ACA: $3400 for individuals, $6750 for families
HR 175: $6550 for individuals, $13100 for families

Can adults under 26 remain on their parents health plans?
ACA: Yes
HR 175: Yes

High-Risk Pools (HR 175 only) - see Note 1 below:
The proposed bill appropriates $15 billion in 2018 and 2019, followed by $10 billion annually, to be distributed across states. States can use this "patient and state stability fund" for a few different things, including setting up a high-risk pool. High-risk pools are expensive endeavors. We don't expect $15 billion across 50 states and DC to be sufficient for states to run high-risk pools.

State Waivers (HR 175 only) - see Note 1 below:
This section of the bill essentially amounts to an optional, state-level full repeal of Obamacare. States could apply for waivers that would allow insurance companies in their states to do three things:
1. Charge older people more than five times what they charge young people for the same policy
2. Eliminate required coverage, called essential health benefits
3. Charge more for or deny coverage to people who have pre-existing health conditions.

Premium Cost (HR 175 only) - see Note 1 below:
"Mini-med" or limited-benefit plans that were prevalent before the ACA in the individual market segment may make a comeback in some states, whereas other states may choose to maintain close to ACA-level essential benefits.

Because the proposed replacement tax credits aren't linked to the underlying costs, individuals in states with higher premiums will see a less-effective benefit than states with lower premium rates.

Average State ACA Premiums (based on a 2015 Bronze-level plan for a 40-year-old non-smoker) - see Note 2:

$475 Alaska
$394 Wyoming
$383 Vermont
$327 New Jersey
$308 Wisconsin
$303 Florida
$290 Connecticut
$288 Massachusetts
$286 Indiana
$274 Louisiana
$272 Maine
$270 North Carolina
$269 Texas
$268 South Carolina
$263 North Dakota
$262 Colorado
$261 Nebraska
$261 Pennsylvania
$258 Ohio
$256 United States (average)
$255 Arkansas
$254 New Hampshire
$252 Deleware
$252 Michigan
$249 California
$247 Georgia
$247 Nevada
$246 Iowa
$246 Virginia
$245 Missouri
$243 Mississippi
$243 South Dakota
$242 Washington
$241 West Virginia
$238 Illinois
$229 Arizona
$228 DC
$228 Rhode Island
$226 Montana
$220 Kentucky
$220 Oklahoma
$217 Alabama
$212 Oregon
$207 Maryland
$207 Utah
$205 Kansas
$205 New Mexico
$200 Tennessee
$195 Minnesota
$171 Hawaii


NOTES:

1 From S&P Global Credit Portal.

2 From Health Insurance Premiums & Increases.

[Greg Schoenberg]

Good research. Thanks!

For RV-ers, a particular advantage of this proposed bill to ACA is that it will increase competition, which in turn could restore plans that have nationwide coverage. Right now the remaining ACA plans are trending out of nationwide coverage as a means to saving costs. An example....Washington state has only one carrier that offers nationwide coverage and it's representative recently told me that they will end that feature next year. (incidentally that particular plan is not available on the exchange).

It appears true that older people will pay more but those who make too much money to acquire any subsidy could be winners. The new subsidy is based on age…not income.

My biggest concern is the elimination of the penalty. It has definitely played a factor in motivating people to buy health insurance for the first time. With it gone, younger and healthier people may choose "live dangerously," knowing they will get care in the emergency room and likely not pay for it. Déjà vu pre-Obamacare.

[rfsod48]

Now we wait for the senate and their changes.

[Barbaraok]

Essential Health Benefits:
ACA: See Essential Benefits.
HR 175: The same as ACA.

I believe this is in error. The proposal is to allow states to get waivers if they want to drop some or all of the essential benefits, such as pre-existing conditions and caps on benefits, also birth control and on and on. Governor of WI has already said he is going to do just that.

[Superslif]

What I'm fearful of now is there is the possibility people in employer / union group plans can get dinged. Having taken the plunge into retirement at age 54, I can only wonder how anyone could afford rates charged for the older / pre-Medicare age group going up.

Things I like with some of the "essential health benefits" was the "Wellness / Preventive" getting people to get checked out before something that would have gone unchecked for years now, can be caught and addressed.

• Ambulatory patient services. [outpatient care]
• Emergency services.
• Hospitalization. [inpatient care]
• Maternity and newborn care
• Mental health and substance use disorder services, including behavioral health treatment.
• Prescription drugs.
• Rehabilitative and habilitative services and devices.
• Laboratory services
• Preventive and wellness services and chronic disease management;
• Pediatric services, including oral and vision care.

? If the WI. Governor were to drop all the 10 essential health benefits, What is left?

[MisterT]

I love the removal of the 'tax penalty' for not purchasing insurance...

while I understand, as an insurance agency owner, that those same folks, especially younger ones, eventually may pay higher premiums because they did not have a 'previous policy'...
I've never liked the idea of anyone having to 'justify' to the government that they either Do, or Don't, have health insurance... and especially as part of your IRS Tax Returns every year.
The marketplace should determine any additional costs, if any - not the government.

We live in the land of the 'free', where people march and protest that the government is interfering with their 'way of life', and yet these same folks will DEMAND that All Citizens must participate in a 'national insurance program' for it to be 'fair' to everyone!(?) really??

You can't, and shouldn't, have it both ways.

congrats on the new bill... hopefully it will stay intact, or even get better.

[MisterT]

Originally Posted by Superslif

Hospitalization. [inpatient care][/LIST][/B]

Healthcare, the 'AFFORDABLE' type, should be about care in a Hospital or associated Outpatient type care... not all the other 'essentials'... UNLESS you want to pay extra for them on your policy.

If you demand all the 'essentials', then you have an 'EXPENSIVE' type of insurance.

[manderson2228]

Originally Posted by Greg Schoenberg

Good research. Thanks!

For RV-ers, a particular advantage of this proposed bill to ACA is that it will increase competition, which in turn could restore plans that have nationwide coverage. Right now the remaining ACA plans are trending out of nationwide coverage as a means to saving costs. An example....Washington state has only one carrier that offers nationwide coverage and it's representative recently told me that they will end that feature next year. (incidentally that particular plan is not available on the exchange).

Are you saying that if you buy an ACA and live in Washington state you don't get coverage outside of the states borders?

[Superslif]

If you demand all the 'essentials', then you have an 'EXPENSIVE' type of insurance.

I would say maybe 4-5 of the list of 10 essential health benefits doing without would bankrupt most people...or severely change their lifestyle.

One hospital stay, One unexpected rehab stay with a back injury, getting prescribed a life saving drug...Unless someone is part of the 1% "class"...Life can change in a minute.

[TechWriter]

Originally Posted by Barbaraok

I believe this is in error. The proposal is to allow states to get waivers if they want to drop some or all of the essential benefits, such as pre-existing conditions and caps on benefits, also birth control and on and on. Governor of WI has already said he is going to do just that.

Barb, the state waivers allow states to nullify much, much more. See the "State Waivers section in my post.

However, as it now stands, the Essential Benefits are part of the HR 175 (unless a state decides to opt out of them).

[Greg Schoenberg]

Originally Posted by manderson2228

Are you saying that if you buy an ACA and live in Washington state you don't get coverage outside of the states borders?

Correct. There is emergency coverage but that's it. Year before there were several nationwide plans available. I had one.

This is not unique to Washington. Popular domiciles like SD and TX do not have nationwide plans. Florida only has one....Florida Blue. Next year????

[Taterpeeler]

Lets let the upper chamber hash it out then go to committee... what you see now is not what you get, to early to even discuss

[manderson2228]

Originally Posted by Greg Schoenberg

Correct. There is emergency coverage but that's it. Year before there were several nationwide plans available. I had one.

This is not unique to Washington. Popular domiciles like SD and TX do not have nationwide plans. Florida only has one....Florida Blue. Next year????

Interesting, i had no idea that was the case.

[TechWriter]

Originally Posted by Taterpeeler

Lets let the upper chamber hash it out then go to committee... what you see now is not what you get, to early to even discuss

I don't think so. If you like/dislike any of HR 175's provisions, then you want to contact your senators to help them hash.