Here are two more I just ran across today. One surprised me, and may be the best one yet, but could be unsustainable if some features aren't adopted. But it's close....
Republican Sens. Bill Cassidy and Susan Collins introduced the first Affordable Care Act replacement bill from the GOP on Monday, called the Patient Freedom Act. Based on the fact sheet for the bill:
1. "Reimplementation of the ACA." This option would allow states to put most of the provisions of the ACA, which is also known as Obamacare, back into place, including the individual mandate and Medicaid expansion. Funding from the federal government would remain the same for Medicaid expansion, cost-sharing subsidies, and premium subsidies up to 95% of current outlays.
2 "Choose a new state alternative." This would allow states to create a "new market-based system" with federal funding "equal to 95% of federal premium tax credits and cost-sharing subsidies" and having "per beneficiary grants or advanceable, refundable tax credits" deposited directly in health savings accounts.
3. "Design an alternative solution without federal assistance." This would allow states to create their own individual market solution with no funding from the federal government.
4. Keep in place a number of provisions of the ACA, including not allowing insurers to deny coverage because of a preexisting condition, allowing children to stay on their parents' insurance until age 26, and prohibiting lifetime limits.
5. It does, however, repeal mandates on certain baselines for coverage (the fact sheet did not specify what types of coverage), the provision that premiums for elderly people can be only three times that of young people, and other clauses.
Not bad right?
Larry Levitt, senior vice president at the Kaiser Family Foundation, a nonpartisan healthcare think tank, said the bill appears to keep a majority of the ACA intact — to the point that it's almost indistinguishable from the original law.
Rand Paul had his own plan, which is a bit stripped down and plainly unaffordable for most people:
Sen. Rand Paul introduced the Obamacare Replacement Act on Wednesday.
1. The bill would remove parts of the Affordable Care Act, including the individual mandate and minimum standards for care. It would also provide a two-year window for people with preexisting conditions to sign up for care.
2. It also includes new provisions such as an expanded ability for insurers to sell plans in multiple states and a $5,000 tax credit that people can put toward a health savings account.
Still...
1. Eliminate several provisions of the ACA, including the individual mandate and minimums on coverage standards. The bill's fact sheet doesn't mention any provision to allow parents to keep a child on their insurance until they turn 26.
2. It's unclear what would happen to people with preexisting conditions in the individual market after the two-year open-enrollment period.
3. Additionally, the bill would provide every American a tax credit worth up to $5,000 for contributions to a health savings account to put toward health insurance and other healthcare costs.
4. Allow insurance companies to sell plans "across state lines." Health policy analysts have said there is little evidence that insurers would take advantage of this provision or that it would drive down costs.
5. Allow HSAs to be used without a high-deductible plan. Currently, HSAs are used only in conjunction with high-deductible plans. Paul's bill would eliminate the link. Additionally, it would allow HSA money to be spent on insurance premiums and prescription drugs.
6. Allow individuals and small businesses to pool together to get insurance.While the ACA allows small businesses to pool together to get more favorable care, this has not been used much. In addition, Paul's plan would allow individuals to pool together to access care — another longtime Republican idea —but his plan would allow this "through their membership in a trade or professional association."
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