Senate Reconciliation Bill
The Senate Finance Committee released legislative text this week. The text included some significant changes from the House Reconciliation bill. A few highlighted changes:
- Medicaid – The Senate version so far would increase the number of Medicaid beneficiaries work requirements would apply to (for example lowering the exemption age of adults with children to 14). One of the largest differences, from a health policy perspective, is that the bill would lower the cap on provider taxes in Medicaid expansion states to 3.5%, down from the current rate of 6%. It would also reduce state-directed payments in expansion states.
- ACA – The Senate version generally mirrors the House version with the exception is that it does not include ICHRA/HRA provisions, nor does it include any of the Program Integrity provisions.
- Medicare – The bill did not include any of the “doc fix” payment increases that was included in the House bill.
Senate Republicans will continue to debate the matter in the coming weeks and changes to the bill are expected. Senate leaders are aiming to have the bill pass the Senate before the July 4th recess although it is possible that timeline will slip.
Analyses on Reconciliation Bill
- CBO Score – CBO released its dynamic score of how the House Reconciliation Bill will affect the economy. CBO estimates that the ill will increase the deficit by $2.4 trillion over the next 10 years, increase real GDP by an average of 0.5 percent, and increase interest rates.
- Urban Analysis – The Urban Institute released analysis on the impact of the House reconciliation bill on the Marketplaces as well as Basic Health Programs (BHP). Urban estimates that the House bill will cause enrollment to decline by one-third or more in most states. Overall, they found that enrollment would decline in these markets by 5 million people.
Tariffs and Premiums
KFF reported that a number of issuers were including the impact of tariffs in premiums for this current rating cycle. While not every issuer explicitly included tariffs in their rate filings, KFF did note that it was a factor in rate setting this cycle.
