Last week, the House Budget Committee voted 19-17 to pass the GOP-backed American Health Care Act. The Act would replace the Affordable Care Act and make several modifications to the current healthcare system in the United States. Although the bill still needs to make it through the full House vote and the Senate, if passed there would be some key changes that businesses and individuals should be aware of.
The new rule would move away from the current premium tax credit system in which subsidies based on income and cost of living are provided to individuals to help buy insurance. Under the proposed rule, people would still receive subsidies but the amount would be based on age. Older people would receive more tax credits, with the caveat that insurers would now be able to charge older consumers up to five times more than younger consumers.
Under the Affordable Care Act, businesses with 50 or more full-time employees, and individuals, are required to purchase health insurance or otherwise pay a penalty tax. The new rule would drop the tax penalty, but has adopted measures to discourage gaps in coverage. Anyone who goes without insurance for more than two months would face a 30% premium surcharge when they buy a new plan.
Currently, businesses with fewer than 25 full-time employees making an average of about $50,000 per year or less qualify for a small business health care tax credit. This is to help pay for employee’s premiums although the business is not required to purchase health insurance under the law. If the new rule passes, this small business tax credit would be repealed by 2020.
Insurance companies will still be required to cover basic benefits like maternity care, prescription drugs, and mental health care. After April 31, 2019, however, Medicaid will not need to offer these basic coverages. The new rule will also drastically reduce Medicaid funds, with each state having a fixed amount of money every year for every person who qualifies for Medicaid. Ultimately, the additional federal funding will be phased out by 2020.
The proposed rule encourages a shift among consumers to HSAs, or Health Spending Accounts. Beginning in 2018, the new rule would increase HSA contribution limits to match the out-of-pocket maximums under a high deductible plan, and non-prescription over-the-counter medications could be purchased with an HSA.
The full House was orginally set to vote on the proposed rulemaking on Thursday March 23, 2017. However, the vote was delayed until Friday March 23, 2017 by House Republicans leaders due to a lack sufficient support to pass the bill.
SGIA continues to monitor this critical rulemaking. Sign up to receive the most up-to-date regulatory and legislative information about specialty imaging.