New Republican healthcare bill keeps parts of ACA while repealing mandates

Rather than attempting to fully repeal the Affordable Care Act, a new proposal from two Republican members of Congress would keep certain provisions while getting rid of mandates on individuals to have insurance and for employers to provide it, as well as removing requirements on what benefits health plans have to offer.

Rep. Pete Sessions, R-Texas, and Sen. Bill Cassidy, R-La., have called the legislation “The World’s Greatest Healthcare Plan.”

The biggest change the bill aims to make is providing a tax credit of $2,500 per adult and $1,500 per dependent child that can be used to purchase insurance, pay for healthcare services or be transferred to a health savings account (HSA). The tax credit could be assigned to an employer if the individual wants coverage through their work.

States would also be allowed to opt out of the ACA marketplaces and create their own systems, and prices for services purchased through an HSA or paid out of pocket would have to be published, which Session argued creates a better environment for consumers to find the most affordable coverage.

“There should be a healthy debate about an option available for the American people who choose not to go to Obamacare, who do not qualify for Obamacare, but who want and need to have healthcare that is sustainable and available for their families,” Sessions said at a May 23 news conference.

The proposal keeps more popular elements of the ACA, such as prohibiting insurers from denying coverage based on preexisting conditions. It also keeps in place tax increases and Medicare cuts, and the legislators promised consumer who are satisfied with current plans purchased off the exchange would be able to keep them.

The legislation has the support of conservative groups like the Goodman Institute, which said in a statement the bill is the “freest enterprise reform ever introduced in the U.S. Congress."

Other groups reacted with skepticism. Kaiser Family Foundation President Drew Altman told The Hill the $2,500 tax credit wouldn’t cover the cost of coverage for low-income households, saying a $6,000 credit would be needed to cover the average cost of an individual plan in the employer market.

While Sessions and Cassidy have been crafting their proposal, a task force put together by House Speaker Paul Ryan, R-Wis., has been working on an ACA replacement plan of its own. From what is known about the House proposal, both plans would affect employer tax credits for insurance, but the Sessions/Cassidy bill doesn’t go as far in making major changes to Medicare and Medicaid and keeps the protections for people with pre-existing conditions, rather than asking states fund “high-risk pools” to cover those individuals.

Cassidy said the two proposals may end up looking quite similar, though he pointed out the task force is only expected to release a white paper of recommendations, rather than actual legislation.

“It’s one thing to speak in principles. It is another to have legislative language,” Cassidy said. “The fact that we’ve written that language will move their product that much further.”

The task force is expected to publicly release its plan in June.