Republican Sens. Bill Cassidy and Susan Collins introduced the first Affordable Care Act (ACA) replacement bill from the GOP on Monday, called the Patient Freedom Act.
Based on the fact sheet for the bill, it’s a curious opening salvo from the party: It appears that the replacement would give states the option to keep nearly all of the law intact if they wish.
The bill has three options for how states can cover people:
- “Reimplementation of the ACA.” This option would allow states to put most of the provisions of the ACA back into place, including the individual mandate and Medicaid expansion. Funding from the federal government would remain the same for Medicaid expansion, cost sharing subsidies, and premium subsidies up to 95% of current outlays.
- “Choose a new state alternative.” This would allow states to create a “new market-based system” with federal funding equaling “equal to 95% of federal premium tax credits and cost-sharing subsidies” and have “per beneficiary grants or advanceable, refundable tax credits” deposited directly in Health Savings Accounts of each person in the state.
- “Design an alternative solution without federal assistance.” This would allow states to create their own individual market solution with no funding from the federal government.
The bill, according to the fact sheet, would keep in place a number of provisions from the Affordable Care Act, including not allowing insurers to deny coverage due to a preexisiting condition, allowing children to stay on their parents’ insurance until age 26, and prohibition of lifetime limits.
It does, however, repeal mandates on certain baselines for coverage (the fact sheet did not specify what types of coverage), the provision that premiums for the elderly can only be three times that of young people, and other clauses.
Larry Levitt, senior vice presdient at the Kaiser Family Foundation, a nonpartisan healthcare think tank, said the bill appears to keep a majority of the ACA intact — to the point that it’s almost indistinguishable form the original law.
“Based on this summary, the … plan basially block grants the ACA with a cut in federal funding of 5%,” Levitt tweeted.
Levitt did add, however, that the final legislative language will be important to determining the impact of the law. Only the fact sheet has been released.
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