Republican senators unveiled their legislation to dismantle the health reform law on Thursday.
Though senators promised to write their own repeal bill, their proposals largely mirror the House legislation. Both would radically overhaul Medicaid, effectively ending Medicaid expansion and greatly reducing federal support for the overall program. Both would get rid of the individual and employer mandates, as well as eliminate taxes on the wealthy, insurers and others.
The Thursday unveiling of the bill was met with protests on Capitol Hill.Members of a group with disabilities were protested the proposed GOP health care plan in front of the office of Senate Majority Leader Mitch McConnell. While it's likely to change before lawmakers vote on it -- possibly late next week -- it's already clear who will benefit and who will lose under the Senate plan.
Winners: Younger Americans could pay less for coverage. Like its counterpart in the House, the Senate plan would lower premiums for younger Americans by allowing insurers to charge older enrollees more. Policyholders age 20 to 29 would save between $700 and $4,000 a year, on average, according to a study by the Milliman actuarial firm on behalf of the AARP Public Policy Institute.
Winners: The wealthy would pay less in taxes. Just as in the House bill, the Senate legislation would eliminate two taxes that Obamacare levied on the wealthy to help pay for the law. Under the Affordable Care Act, single taxpayers with incomes above $200,000 and couples making more than $250,000 annually have to pay an additional 0.9% Medicare payroll tax on the amount they earn above these thresholds.
Winners: Insurers would receive more federal funds. Aiming to stabilize the individual market in the near term, the Senate would allocate funds for the cost sharing subsidies until 2019. These payments reduce the deductibles and co-pays for more than half of policyholders on the Obamacare exchanges.
Losers: Lower-income Americans could be left uninsured. About 11 million Americans gained coverage under Obamacare's Medicaid expansion provision. The Senate bill would eliminate the enhanced federal funding for the program by 2024. While that extends Medicaid expansion's life for a few years longer than the House bill, the end result is the same: Low-income adults would likely be kicked off the rolls.
Older enrollees would see premiums soar. Americans in their 50s and early 60s benefited from Obamacare because insurers could only charge them three times more than younger policyholders. The bill would widen that band to five-to-one. That would mean that adults ages 60 to 64 would see their annual premiums soar 22% to nearly $18,000, according to the Milliman study for the AARP.
Losers: Those with pre-existing conditions or opioid addictions may receive fewer covered services. Under Obamacare, insurers must provide 10 essential health benefits, including maternity, mental health, substance abuse and prescription drugs. The Senate bill would allow states to seek waivers of this provision, opening the door for insurers to offer less comprehensive policies.