The Cassidy bill would repeal both the employer and individual insurance mandates in Obamacare while retaining the more popular consumer protections allowing people to stay on their parents’ plan through age 26 and banning discrimination based on pre-existing conditions. It would still require insurers to cover mental-health and substance-abuse disorders. States could choose to continue to run ACA exchanges and expanded Medicaid, although there would be a 5 percent cut in federal support for subsidies and tax credits. Or they could receive the same level of federal funding to pursue a more conservative program based on expanded health savings accounts and high-deductible plans, which are the hallmarks of many Republican proposals to replace Obamacare.
Whether the Cassidy proposal could function as intended is unclear. The ACA is a complex and highly interconnected law, and its proponents have argued that keeping popular provisions while removing the mandates designed to make them affordable would be nearly impossible. States could also auto-enroll residents in basic health plans, which Cassidy said was designed as an alternative to the ACA’s requirement that individuals buy insurance or pay a tax penalty. Maintaining a large enough pool of healthy people enrolled in coverage, he acknowledged, was essential to continuing the ban on insurance companies being allowed to deny plans to consumers with conditions that would be more expensive to cover.
Another challenge for Cassidy and his colleagues is that their proposal represents a compromise at a moment when neither side of the healthcare fight is ready for one. Democrats attacked the plan for its funding cuts and for the likelihood that many Republican-led states would choose to abandon the federal law and kick millions of their residents off the exchanges and Medicaid. “Ultimately, this proposal is an empty facade that would create chaos—not care—for millions of Americans,” Senate Minority Leader Charles Schumer said.
Join the conversation as a VIP Member