Sens. Collins's & Cassidy's Plan to Replace Obamacare With the “Patient Freedom Act” (S. 191)
Do you support or oppose this bill?
What is S. 191?
(Updated April 12, 2018)
This bill — known as the Patient Freedom Act of 2017 — would look to replace Obamacare by preserving some portions of the law and repealing others and giving states the option of keeping their exchanges or developing a new alternative. It would repeal the individual and employer mandates, the requirements that healthcare plans fit into four categories, age requirements that drive up prices for the young, and benefit mandates. It would keep certain consumer protections, like the prohibition on excluding people with pre-existing conditions, letting individuals stay on their parents’ plan until they’re 26, and preserving coverage for mental health and substance abuse disorders.
States would be able to choose one of three options:
Reimplement the ACA: States could reinstate Obamacare’s mandates and other requirements. Under this option they’d be able to continue receiving federal premium tax credits, cost-sharing subsidies, and Medicaid dollars as long as those subsidies don’t exceed the contributions that’d be made under the second option.
Choose a New State Alternative: States could enact a new market-based system that empowers patients while still protecting those with pre-existing conditions. It could continue to receive funding equal to 95 percent of federal premium tax credits and cost-sharing subsidies plus the federal Medicaid match. They could receive funds in the form of beneficiary grants or advanceable, refundable tax credits — but in both cases funds would go directly to the patient by being deposited into a Roth Health Savings Account.
Design an Alternative Without Federal Assistance: States could choose to design and regulate insurance markets that work for their specific populations without any federal assistance.
Argument in favor
This Obamacare replacement would empower states to design an alternative that meets their needs and ensure that some of its important consumer protections are preserved, while expanding access to affordable health insurance and giving consumers more options.
Argument opposed
This bill doesn’t really repeal Obamacare, instead allowing states that like the status quo to keep things the way they are. That doesn’t go far enough, as the health insurance industry needs a complete overhaul and some states keeping things as they are will impede that.
Impact
People who have or acquire health insurance; employers; health insurance providers; states; and the federal government.
Cost of S. 191
A CBO cost estimate is unavailable.
Additional Info
In-Depth: Sponsoring Sen. Bill Cassidy (R-LA) introduced this bill to replace Obamacare while giving states the option of reinstating the law’s mandates or designing their own alternative with or without federal assistance:
“We have been stressing the importance of making sure we have a replacement plan ready to go with the repeal of Obamacare, in order to ensure that no one sees a gap in their health care coverage. With the introduction of the Patient Freedom Act of 2017, I believe we now have that plan. President Trump has said that he wants to have health care coverage for all under the replacement plan. The Patient Freedom Act does this and more.”
Detractors have criticized this bill for allowing too much of Obamacare to live on if states choose to keep it. In the Washington Examiner, Philip Klein called it “Obamacare Forever” because it keeps taxes and spending in place, along with the federal insurance exchanges. Klein also said that the federal regulations that would remain intact, including those for preexisting conditions and letting adults up to age 26 remain on their parents’ plans, which would mean “any state that opts out of Obamacare would continue to be restricted by its regulatory tentacles.”
This legislation has the support of three additional Republican cosponsors in the Senate aside from Sen. Susan Collins (R-ME), including Sens. Shelley Moore Capito (WV), Johnny Isakson (GA), and Lindsey Graham (SC).
Media:
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Cosponsoring Sen. Susan Collins (R-ME) Press Release
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Sponsoring Sen. Bill Cassidy (R-LA) One Pager
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CNN
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Vox
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Washington Examiner (Op-Ed Opposed)
Summary by Eric Revell
(Photo Credit: Medill DC / Creative Commons)
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