- Sen. Rand Paul introduced the Obamacare Replacement Act on Wednesday.
- The bill would remove parts of the Affordable Care Act, including the individual mandate and minimum standards for care. It would also provide a two-year window for people with preexisting conditions to sign up for care.
- It also includes new provisions such as an expanded ability for insurers to sell plans in multiple states and a $5,000 tax credit that people can put toward a health savings account.
Sen. Rand Paul, the libertarian-leaning Republican and onetime presidential candidate, introduced his version of a replacement for the Affordable Care Act, better known as Obamacare.
The bill, named the Obamacare Replacement Act, would eliminate several provisions of the ACA, including the individual mandate and minimums on coverage standards. The bill's fact sheet doesn't mention any provision to allow parents to keep a child on their insurance until they turn 26.
Interestingly, Paul's plan would provide a two-year window for people with preexisting conditions to sign up for care. It would then revert to pre-ACA rules in which people with preexisting conditions could still get coverage in the group market. It's unclear what would happen to people with preexisting conditions in the individual market after the two-year open-enrollment period.
Additionally, the bill would provide every American a tax credit worth up to $5,000 for contributions to a health savings account to put toward health insurance and other healthcare costs.
"Getting government out of the American people's way and putting them back in charge of their own healthcare decisions will deliver a strong, efficient system that doesn't force them to empty out their pockets to cover their medical bills," Paul, who is also an ophthalmologist, said in a press release announcing the bill.
However, Paul also said that a repeal of the ACA should not move forward without a replacement ready to go.
"There is no excuse for waiting to craft an alternative until after we repeal Obamacare, and the Obamacare Replacement Act charts a new path forward that will insure the most people possible at the lowest price," the release said.
Paul was the only Republican senator to vote against a resolution that kicked off the ACA repeal process, citing concerns that a repeal without replacement would increase the federal budget deficit.
According to the fact sheet, Paul's bill would change the healthcare market in several other ways. Here are the highlights:
- Allow insurance companies to sell plans "across state lines." This is a popular Republican idea but was included in a more limited form in the ACA. While each insurance company currently has to comply with state insurance regulators, Paul's plan would eliminate this need for compliance. Health policy analysts have said there is little evidence that insurers would take advantage of this provision or that it would drive down costs.
- Allow HSAs to be used without a high-deductible plan. Currently, HSAs are used only in conjunction with high-deductible plans. Paul's bill would eliminate the link. Additionally, it would allow HSA money to be spent on insurance premiums and prescription drugs.
- Allow individuals and small businesses to pool together to get insurance. While the ACA allows small businesses to pool together to get more favorable care, this has not been used much. In addition, Paul's plan would allow individuals to pool together to access care — another longtime Republican idea —but his plan would allow this "through their membership in a trade or professional association."
This is the second replacement bill to be advanced in the past week by Republicans; the first was a bill from Sens. Bill Cassidy and Susan Collins. Paul's bill, however, would eliminate more of the ACA's programs and protections than Cassidy and Collins' bill would.
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