Can get insurance through a parent’s plan or buy independently.
Stays the same.
Stays the same.
Stays the same.
Can buy insurance on health exchanges, with tax credits and subsidies if they meet income requirements up to 400 percent of poverty level. Cost of insurance is based on tobacco use and age, with the people nearing 65 paying no more than three times what the youngest pay. Premiums can’t cost more than 9.5 percent of income. Those with very low or no income qualify for Medicaid.
The Congressional Budget Office report for this bill estimates that about 24 million fewer people will have insurance in 2026 than if current law stays intact. The bill has tax credits to pay premiums, but they are based primarly on age, not income, and max out at $4,000, much less than under the ACA. The oldest people under 65 can be charged five times more than the youngest, and maybe more depending on state rules. Medicaid cut after 2020.
The CBO report says 22 million people would lose health insurance over the next 10 years, with people between 50 and 64 disproportionally impacted. The oldest people under 65 would pay five times more than younger people on the exchanges. Subsidies to help pay for insurance would be less, and end at incomes of 350 percent of poverty level. This would make deductibles in many cases very high. Federal contributions to Medicaid start to decline in fiscal year 2020. A revision allows subsidies to be used to buy plans that offer only catastrophic care, and consumers could use health savings accounts to pay premiums.
According to a CBO report released July 19, the repeal bill would repeal major provisions of the Affordable Care Act, including the federal Medicaid expansion funding, the premium tax credits and cost-sharing subsidies, the individual mandate and the employer mandate. The CBO said that 17 million people would lose health insurance in 2018, rising to 32 million people by 2026. Premiums on the exchange would rise by 25 percent in 2018, increasing to 50 percent in 2020. In addition, roughly 10 percent of the population would live in areas where there would not be any insurer in the individual market in 2018. That would rise to half of the nation’s population in 2020, and three-quarters of the population in 2026.
Skilled nursing care covered by Medicare up to 100 days per illness. Medicaid is available based on income.
Skilled nursing care covered by Medicare up to 100 days per illness. Medicaid services or payments to nursing homes could be cut as states see federal funding decline.
Skilled nursing care covered by Medicare up to 100 days per illness. Medicaid coverage for nursing home services and payments to nursing homes could be cut as federal payments to states decline.
Skilled nursing care covered by Medicare up to 100 days per illness. Medicaid services or payments to nursing homes could be cut as states see federal funding decline.
Coverage cannot be denied or cost more.
States can get permission to let insurers charge more for some pre-existing conditions and to exclude some people altogether. States would have access to federal money to help those with expensive policies or conditions.
Insurance companies would be required to accept all applicants regardless of health status. But the draft bill lets states ask permission to reduce required coverage, also called “essential health benefits,” which would give insurers some discretion over what they offer in their plans. That could result in “substantial increases” in costs for people who want those services, according to the CBO. If a particular benefit is no longer classified as essential, insurers could impose annual and/or lifetime limits on what they spend on patients for that benefit. And caps on the annual out-of-pocket costs for patients would no longer apply.
Insurance companies would be required to accept all applicants regardless of health status. The 10 ACA-mandated essential health benefits would also remain in place. But the provisions that repeal the individual and employer mandate would mean that healthier people would likely drop insurance and prices would rise for consumers who continued to purchase it — in other words, sicker people. The CBO estimates prices would be about 50 percent higher in 2020 and about double by 2026.
Federal programs reimburse for most Planned Parenthood services.
A one-year block would be placed on federal reimbursements for care provided by Planned Parenthood. The CBO estimates 15 percent of low-income women who already have reduced access to care would completely lose access to family planning care, increasing birthrates and Medicaid spending for childbirth and children’s insurance. But those increases would be offset by Planned Parenthood cuts.
A one-year block would be placed on federal reimbursements for care provided by Planned Parenthood. The CBO estimates 15 percent of low-income women who already have reduced access to care would completely lose access to family planning care, increasing birthrates and Medicaid spending for childbirth and children’s insurance. But those increases would be offset by Planned Parenthood cuts.
A one-year block would be placed on federal reimbursements for care provided by Planned Parenthood.
The majority of Medicaid dollars go to people with disabilities.
May qualify for Medicare and also Medicaid.
May qualify for Medicare and also Medicaid. But services covered by Medicaid could be cut as federal funding to states declines over time.
May qualify for Medicare and also Medicaid. But services covered by Medicaid could be cut as federal funding to states declines over time. The CBO report suggests that by 2026, Medicaid enrollment would fall by more than 15 million people.
May qualify for Medicare and also Medicaid. The elimination of federal Medicaid expansion funding could have ripple effects to people with disabilities as states would have to decide whether to make up lost funding, trim services or limit who can get Medicaid. Laws would remain on the books that Medicaid would need to cover those with disabilities, but in some states, people could face long waits (months to years) to get those benefits.
Covered by all plans under essential health benefits.
Could lose coverage in states that get waivers from covering essential health benefits.
States could request waivers to opt out of requiring essential health benefits. If a state opted out of coverage for mental health care, insurance that includes mental health care coverage could become “extremely expensive,” the CBO says.
Mental health coverage would remain intact as one of the 10 essential health benefits. However, without the mandate that people must have insurance, it is likely that only people who require robust coverage would continue to purchase it, and prices would go way up for those plans on the individual market. Essential health benefits would be done away with in Medicaid.
Thirty-one states and the District of Columbia offer expanded Medicaid coverage.
Federal funding for Medicaid expansion phases out, potentially affecting millions of people who are currently enrolled under the expansion.
Federal funding for Medicaid expansion phases out between 2021 and 2023. In addition, eight states have a trigger clause — if the federal matching rate declines below the ACA-promised rates, the expansion goes away immediately in Arkansas, Illinois, Indiana, Michigan, Montana, New Hampshire, New Mexico and Washington. Further reductions would start in 2025. In a separate provision, states could impose a work requirement on recipients. Most able-bodied adult Medicaid recipients already work.
Federal funding for Medicaid expansion would phase out over two years. Eight states have a trigger clause. If the federal matching rate declines below the ACA-promised rates, the expansion goes away immediately in Arkansas, Illinois, Indiana, Michigan, Montana, New Hampshire, New Mexico and Washington.
Pay extra taxes to support ACA.
The bill would repeal ACA taxes on corporations and cut taxes for the wealthy by about $592 billion.
Similar to the House bill; would repeal ACA taxes on corporations and the wealthy that pay for insurance subsidies. That would add up to about $563 billion in tax cuts over 10 years, according to the CBO. A revision keeps some of the ACA’s taxes on higher-income people. But the permission for flexible spending accounts to be used for premium payments will be a tax advantage for those who can afford to put money aside.
The bill repeals taxes on corporations and the wealthy. According to the CBO’s July 19 estimate, that would add up to $613 billion in tax cuts over 10 years.
This chart was last updated on July 20, 2017.