What the latest health overhaul push means for consumers

Only one thing is certain for insurance shoppers if the latest attempt to replace former President Barack Obama’s health care law succeeds: Uncertainty.

Will you be able to get coverage? How much will it cost? Will it cover my conditions?

It depends.

The proposal, sponsored by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, would shift funding and key coverage decisions for both private insurers and Medicaid to states instead of the federal government. That means the availability and price of coverage could vary dramatically from state to state.

The measure is the subject of hot debate in Washington, and senators may vote on it later this week, but its prospects are shaky. Republicans released a revised version Monday morning in hopes of convincing a few crucial holdouts. If three Republican senators oppose the bill, it will die. Arizona’s John McCain and Kentucky’s Rand Paul say they will not support the bill, and Texas’s Ted Cruz and Maine’s Susan Collins have said they would either oppose it or are leaning that way.

If the proposal does become law, some changes would be immediate, but the biggest ones would happen two years from now and depend on how states and insurance companies decide to operate under the new system.

The Affordable Care Act expanded the Medicaid coverage program for the poor in many states and created health insurance exchanges or marketplaces where shoppers could buy private coverage with help from tax credits. The Graham-Cassidy bill would halt that expansion and could trigger big changes in the marketplaces. Here’s a look at what we know and don’t know:


You will no longer have to pay a fine for not having coverage. That penalty can climb up to around $2,000 depending on household income and is one of the most unpopular elements of the ACA. The Graham-Cassidy bill removes it retroactively as well as for future years. So if you didn’t buy coverage this year, you won’t have to pay a fine.

The penalty for companies with 50 or more full-time employees that do not offer coverage also would go away. Employer-sponsored coverage is the most common form of health insurance in the United States, covering an estimated 151 million people under age 65, according to the non-partisan Kaiser Family Foundation, which studies health care issues.


The bill would repeal the ACA’s Medicaid expansion and tax credits that help pay for private coverage for…

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