The GOOD:
– Repeals many of the troublesome Obamacare taxes, including the Cadillac tax on high-cost health insurance plans, unpopular medical device tax, and Medicare tax on high-income recipients, among others.
– Nullifies the employer mandate and retroactively nullifies penalties dating back to December 31, 2015.
– Raises the contribution limits to Health Savings Accounts (HSAs) by January, 2018.
– Reduces the enhanced federal match rate for the Medicaid expansion populations from 90% to 85% by 2021, 80% by 2022, and down to original FMAP of 75% by 2024.
– Restricts retroactive eligibility for individuals receiving Medicaid benefits from 3 months to 1 month beginning in October 2017, further discouraging individuals from jumping on rolls simply when medical expenses arise without paying consistent premiums.
– Creates a Medicaid block grant program for the states beginning in 2020.
– Encourages states to be innovative with their waivers by eliminating requirement that states put waivers into statute and instead, allows state insurance departments and governor’s administrations to have authority and flexibility over the process.
The BAD:
– Permits Obamacare’s system of insurance subsidies to continue being administered through the tax code.
– Gives too much authority to Washington bureaucrats with respect to the creation of “stability funds” to insurance companies and too much jurisdiction over Medicaid programs.
– Expands insurance subsidies authorized in Obamacare, creating a dangerous precedent for the corporate welfare state.
– Appropriates tax dollars for cost-sharing reductions beyond that which is minimally necessary to provide a bridge from Obamacare to repeal.
The UGLY:
– Retains Obamacare Medicaid expansion dollars, though reduced over time, through 2024. Seven years is well beyond what is necessary for states to adjust their budget obligations and creates to big a window for recension.
– Fails to repeal any of Obamacare’s regulations upon insurance companies, which are largely responsible for driving up costs for consumers. Despite allowing some opportunities for exemptions through the waiver process, the lack of any immediate federal reform will continue to make insurance vastly unaffordable.
– Continues to place states at the mercy of the federal government with regards to the management of their own healthcare markets. The feds have picked elements of Obamacare here or there for states to request exemption from through the waiver process, meaning states must continue getting permission from Washington for the flexibility they need to adequately address the healthcare needs of their state.
– The senate proposal maintains the subsidy cliffs within Obamacare that provide disincentives to work. Individuals still stand to lose thousands in benefits due to very slight increases in their income that make it illogical for them to earn more money.