Republicans add continuous-coverage provision to BCRA

Senate Republicans amended the Better Care Reconciliation Act Monday to include a provision that would replace the ACA's individual mandate, The New York Times reports.

The new version of the bill, which is intended to repeal and replace much of the ACA, would instead encourage health insurance enrollment through a continuous-coverage provision beginning in 2019. This provision requires enrollees buying insurance in the individual market to demonstrate a year of continuous coverage to enroll again. If a person goes uninsured for more than 63 days in the year prior, they will be subject to a 6-month "waiting period," meaning they will be locked out of insurance coverage for six months if they do not maintain continuous coverage.

The provision was added with the idea it would encourage people to buy into the market instead of waiting until they are sick to buy coverage, which increases prices for payers. It essentially replaces the ACA's individual mandate, which would be repealed under the BCRA. The individual mandate charged tax penalties to anyone not enrolled in health insurance. The continuous coverage provision is also similar to the ACA's requirement that any enrollees who let coverage lapse in a given year must wait until the next enrollment period to sign up again, according to The New York Times report.

The CBO score released Monday rated this provision as marginally effective. It would "slightly increase the number of people with insurance, on net, throughout the 2018-2026 period," the report reads. However, the CBO expects the continuous coverage provision to have a delayed effect because the bill will cause premiums to spike initially before falling in 2020 and beyond.


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