Republican lawmakers zeroed in on healthcare legislation June 19 as President Donald Trump's administration released a final rule on association health plans and House Republicans proposed a 2019 budget that would pave the way for a repeal of the ACA and make deep cuts to Medicare and Medicaid.
Here are nine things to know about the developments:
1. House Republicans released a 2019 budget proposal that would balance the budget by 2027 by enacting $8.1 trillion in spending cuts, according to Bloomberg. The budget would cut $537 billion from Medicare over the next decade and give eligible seniors the option of enrolling in private "premium support" plans to compete with traditional Medicare coverage, according to The Washington Post.
2. The GOP plan would limit per capita payments for Medicaid or give states the option to convert their Medicaid plans into block grant coverage. It also proposes imposing work requirements on eligible Medicaid enrollees and includes $1.5 trillion in cuts to Medicaid and other health programs.
3. Under reconciliation rules, the budget would allow the Senate to cut at least $302 billion in spending with only 50 votes, without the threat of Democratic filibuster. This would allow Republicans to once again attempt to repeal the ACA. "This budget assumes Congress repeals Obamacare and replaces it with a patient-centered, free-market healthcare system," the proposal's authors write.
4. The House Budget Committee is looking to pass the proposal before the end of the week, though it is unknown if GOP leadership will bring it to the full House for a vote, according to The Washington Post.
5. The Trump administration also issued a final rule June 19 that gives more leeway to small businesses looking to create health insurance plans that bypass many ACA regulations, but lower member expenses, according to The New York Times. The rule is in response to an executive order signed by President Trump Oct. 12.
6. The association health plans, which allow groups such as community organizations, churches and professional associations to band together to purchase or offer health insurance, will be exempt from certain ACA mandates. Offering coverage for "essential health benefits" like emergency services, maternity and newborn care, mental health, and prescription drugs will not be required.
7. While the rule will not allow new association health plans to deny coverage or raise premiums based on pre-existing conditions, it will let plans raise premiums based on age, gender and industry. In addition, states will maintain regulatory authority over the association health plans, and the Department of Labor said it will monitor whether the plans are compliant.
8. The Congressional Budget Office projects 400,000 previously uninsured Americans would gain coverage under association health plans. During a speech in front of the National Federation of Independent Business June 19, President Trump said the new rule will let small businesses "escape some of Obamacare's most burdensome mandates. You're going to save massive amounts of money and have much better healthcare. It's going to cost you much less," according to the NYT.
9. Consumer groups and some state officials who oppose the rule argue association health plans will draw healthy individuals out of the ACA's individual marketplace, which will increase costs for Americans buying more comprehensive coverage, according to the report.