- Revenue generators (taxes, fees) left in place.
- Annual and lifetime limits remain.
- Family plans still allow kids up to 26.
- States can choose one of three (really four) options:
- Keep running the ACA as is
- Bail on the ACA entirely
- Take the same amount of federal money you’d get for the Medicaid expansion and subsidies and instead give it directly to your people, who will be automatically enrolled in a high deductible catastrophic plan. The money they get is based on age, not income though.
- Leave the Medicaid expansion in place and instead do #3 only for the exchange market
I have no idea why any state would choose #2, but that’s me.
- Pros – Many states will keep ACA as is. Medicaid expansion, too. Much of ACA left intact.
- Cons – Many states will bail. It’s likely that states choosing option #3 (or #4) will have plans with fewer benefits. Poor people will be hit hardest, as subsidies not tied to income. (Austin reminds me that there’s a 5% cut in all subsidies)
- Pros – States get to choose. Subsidies tied to age, not income. More defined contribution than defined benefit. Might get some “compromise” points. (There’s also the 5% cut in all subsidies)
- Cons – Leaves much of ACA intact (taxes and fees). Leaves feds still on the hook for a lot of $$$. Some will not view this as repeal.
Let’s be honest, though. At the moment, there’s no reason for Dems to support this. It will piss off a lot of conservatives. It runs counter to President Trump’s EOs. I see no support in leadership. And, there’s no score or details on this yet. If this were pre-ACA, I might view this like Wyden-Bennett. But in today’s climate, I don’t see how this gets much support from either side at the moment.