How Republicans' next Obamacare repeal plan could affect you

USA TODAY

WASHINGTON — In the wake of Monday's collapse of their most recent proposal to replace the Affordable Care Act, Senate Republicans are turning to a bill that would repeal the law in stages, creating a two-year timeline to pass a replacement.

The bill that Senate Majority Leader Mitch McConnell, R-Ky., plans to turn to next was approved by the House and Senate in 2015 but vetoed by then-president Barack Obama. It would end the law’s mandates for people to obtain insurance and scrap the federal subsidies to help pay for them. But it would keep the regulations on what insurers have to cover and the requirement that they not turn down sick people seeking coverage.

That would make the insurance market unstable, increase premiums and dramatically increase the number of people without insurance, according to an analysis by the nonpartisan Congressional Budget Office.

It's unclear what Republicans — who have struggled to agree on a better approach — will be able to pass to replace Obamacare. It’s also unclear whether Republicans have enough votes to consider the bill, even though a majority of Senate Republicans voted for it in 2015, when they knew Obama would veto it.

"President Trump will sign it now," McConnell said Tuesday.

Here’s a look at how the repeal bill could affect you if Senate Republicans can pass it:

Would you get a tax cut?

The bill would repeal taxes the ACA imposed to pay for expanding health coverage to more Americans. Those include taxes on investment income, higher earnings, tanning beds, sectors of the health care industry and on high-cost employer-provided insurance plans.

Would you still have to buy insurance?

You would no longer face a tax penalty for failing to obtain insurance coverage.

Would your employer still have to offer coverage?

The bill would repeal the ACA’s penalties for larger employers who don't offer insurance to workers.

Would you get help paying for private insurance?

The bill would end in two years the tax credits that help moderate and low-income people — up to about $84,650 for a family of three — pay for premiums if they’re not offered coverage through an employer. It would also end the subsidies that help people earning up to 250% of the poverty rate cover other out-of-pocket expenses such as deductibles.

Would insurers still have to sell insurance to people with pre-existing conditions?

The bill would retain the ACA’s ban on insurers denying coverage to sick people and would still prohibit insurers from basing premiums on customers' health status. Insurers would also still be required to cover specific benefits and couldn’t cap annual and lifetime payouts.

Could older people be charged more?

The bill also would not eliminate the ACA’s rule that people in their 60s can’t be charged more than three times as much people in their 20s.

Would young adults be able to stay on their parents’ plan?

The bill would not change the ACA’s rule that dependent children can stay on a parent's plan until age 26.

How much would insurance cost?

Because the bill would end the penalties for not having insurance and phase out the subsidies to make coverage more affordable, younger and healthier people would be less likely to buy insurance. And because insurers could not deny coverage to the sick, premiums would rise. Plans could cost about 50% more right after subsidies are eliminated and could double in 10 years, the CBO has estimated.

Would insurance still be available?

Faced with fewer customers with higher expenses, some insurers would likely stop selling plans. About half the country could have no option in the first year after subsidies are eliminated. After 10 years, three out of four Americans might not be able to buy a plan on the individual market, according to the CBO.

What would happen to people on Medicaid?

After two years, the federal government would no longer pick up the majority of the cost for people who became eligible under Obamacare for the jointly funded federal and state health care program for the poor. But unlike the bill the House passed and the Senate was unable to bring up, a repeal bill would not reduce federal support for traditional Medicaid.

What would be the overall effect on insurance coverage?

The number of people who are uninsured would rise by an estimated 18 million initially, growing to about 32 million in 10 years.

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