Comparing congressional health overhaul bills
The health care bill unveiled by the Senate on Thursday has many similarities to the House bill passed in May. Both
would make major changes to the Affordable Care Act or Obamacare. Key provisions in the law that would change:
ISSUE CURRENT LAW
Medicaid States have the option to expand
expansion Medicaid to cover more low-income
adults, with the federal government
picking up most of the cost.
Pre-existing People cannot be denied coverage due
conditions to pre-existing medical problems, nor
can they be charged more because of
poor health.
Subsidies Provides income-based subsidies to
for help with premiums and out-of-pocket
insurance costs such as deductibles and
copayments; subsidy benchmark tied
to mid-level silver plans.
Standard Requires insurers to cover 10 broad
health essential services such as hospitali-
benefits zation, prescriptions, substance
abuse treatment, preventive services,
maternity and childbirth.
Coverage Requires those deemed able to afford
mandates coverage to carry a policy or risk
fines from the IRS; requires larger
employers to offer coverage to
full-time workers.
Tax cuts Raised taxes on upper-income people
and health-care companies to finance
coverage expansion.
The health overhaul bills journey from here
The Senate puts its own version of
the bill on the floor for debate. Senate
rules prevent this kind of bill from
being filibustered, or talked to death.
The bill goes to the White
House, where President Donald
Trump is expected to sign it.
Sources: Department of Health and
Human Services; House of Represen-
tatives; Senate Budget Committee;
U.S. Senate; AP
HOUSE BILL SENATE BILL
Beginning in 2020, reduces the Phases out Medicaid expansion between
federal match for expanded 2020 and 2023; exempts spending
Medicaid; ends programs status as on special-needs children from cap on
an open-ended entitlement. federal matching contribution.
States can seek waivers to let There is no penalty for having a break
insurers charge more based on health in coverage and no waiting period for
status in some cases; consumers who consumers to use their insurance; states
let coverage lapse pay a 30 percent cannot seek waivers that would allow
premium penalty for a year. insurers to charge more based on health.
Premium subsidies tied to age, not Premium subsidies tied to age, income
income; ends cost-sharing subsidies and geography and are focused more
in 2020. on low-income people; benchmark for
subsidies is tied to bare-bones bronze
plans.
Allows states to seek waivers from Allows states to seek waivers from the
the benefits requirement. benefits requirement.
Repeals coverage mandates. Repeals coverage mandates.
Cuts taxes by more than $600 Tax cuts from House bill are virtually
billion, with most benefits going unchanged.
to high-income households, drug
companies and insurers.
The Senate votes
(51 needed to pass; Republicans hold a 52-48 majority).
PASSES FAILS
A joint conference committee resolves
differences between the Senate and House bills.
The bill dies,
leaving GOP
A final version of the bill must be voted on again to start over.
by both chambers.
PASSES FAILS
Las Vegas Review-Journal