Senate GOP Releases Revised Health Care Reform Bill, Fate Remains Unclear

Federal Health Care Reform

The Senate has released a revised version of its 2017 reconciliation bill (a.k.a. the Better Care Reconciliation Act of 2017), which includes some changes from the first bill that was floated last month that are notable to employers.  It remains unclear at this time whether Senate Majority Leader Mitch McConnell (R-KY) has the votes to proceed with the revised bill or if additional changes will have to be made.   For employers, the most significant changes from the first Senate bill include:

• Both ACA Medicare taxes on high-income Americans are kept in place.  The original bill would have repealed the Medicare investment tax in 2018, and eliminated the Medicare payroll surtax in 2023.
• The bill would allow people to use their HSAs to pay for individual plan premiums—a policy change intended to increase health care coverage.
• The remuneration tax on executive compensation for certain health insurance executives would be kept.  The original bill repealed the tax in 2018.
• $45 billion would be dedicated for substance abuse and opioid treatment and recovery.  The original bill included $2 billion for such purposes.

The revised Senate bill, like the first version, would also:

• Zero out the employer penalty for not offering affordable, minimum value coverage;
• Maintain the ACA benefit mandates on employer-provided coverage;
• Delay the ACA's Cadillac Tax from 2020 to 2026, and repeal all other ACA taxes except for the taxes discussed above; and
• Significantly increase the contribution limits on Health Savings Accounts and their flexibility.