Republican Senators Propose PPACA Replacement

Sens. Richard Burr (R-N.C.), Tom Coburn (R-Okla.) and Orrin Hatch (R-Utah) have introduced legislation that would repeal and replace the Patient Protection and Affordable Care Act.

The Patient Choice, Affordability, Responsibility, and Empowerment, or CARE, Act would do away with many core PPACA provisions such as the individual mandate, which requires people to purchase health plans or pay a fine. The proposal also forgoes a section of the PPACA banning insurance companies from charging older, sicker people more than three times what they charge young, healthy enrollees.

Furthermore, under the CARE Act, people with pre-existing conditions would only have "continuous coverage" protection, meaning health insurers wouldn't be able to deny them coverage as long as those with pre-existing conditions maintained "continuous coverage from one plan to another."

While the PPACA gives states the option of expanding Medicaid, the CARE Act would give states more flexibility to allow them to reform their health insurance programs for the poor. For instance, the proposal would require HHS to respond to Medicaid waiver requests in a timelier manner and give states the option to negotiate a broad, outcome-based program operational agreement with CMS.

Compared with the PPACA, the proposal would also scale back the financial aid available to health plan enrollees, allowing only people with annual incomes of 300 percent of the federal poverty level or less to receive tax credits to help cover the cost of health insurance premiums. Under the PPACA, people who earn 100 to 400 percent of the poverty level are eligible for tax credits for the cost of health plans purchased through the exchanges.

The CARE Act does leave some of the PPACA provisions intact: It would prohibit insurers from imposing lifetime limits on consumer benefits, require pricing transparency from hospitals and health insurers and allow dependents to stay on their parents' health insurance plans until they turn 26.

Liberal groups have criticized the plan, particularly its modifications to the coverage guarantee for those with pre-existing conditions, according to a report from The Hill. The progressive group Americans United for Change has called the proposal a joke, and "a sick one at that," according to the report.

More Articles on the PPACA:
White House Dismisses Concerns About Lack of Young, Healthy PPACA Enrollees
5 Things to Know About the Supreme Court Review of the PPACA Contraceptive Mandate  
Poll: Negative Views of PPACA Marketplaces Decline 

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