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It is widely known that Republicans, in an effort to strengthen their position for the upcoming elections, have demonstrated in their Patient CARE act that they intend to make ACA an easier option for Americans through a significant number of changes. The act’s, which is an acronym for Choice, Affordability, Responsibility and Empowerment, changes target the weaker sections of PPACA, and hope to change the way the healthcare law functions at the moment. However as with any change it might cause more confusion and disruption.

The ACA, although far from perfect, is still a powerful solution and the industry thought is that repealing it now, or after elections, is not an option. However, that doesn’t mean that Congress isn’t trying. On March 5th, the House passed its 50th attempt in derailing the act. But let’s put that aside and look what they are proposing.

1)    Cancellation of Medicaid Expansion – One of the core components, and most widely criticized,   of ACA is the Medicaid expansion.  Twenty-six states, including DC, have chosen to expand Medicaid and four are considering expansion. The CARE act seeks to end the Medicaid expansion and cap the unlimited funding, except for the elderly and disabled.

2)    Lowering of Insurance Subsidies –Under the CARE act, insurance subsidies would only be available to people earning up to three times of the federal poverty level. Currently, the ACA has eligibility to people earning up to four times the federal poverty level.

3)    Lowering Employer Health Insurance Tax Exclusion – The act seeks to cap the employer health insurance exclusion at 65 percent, which would make 35 percent of a plan’s value taxable for employees, while maintaining employer tax deductions under the ACA.

4)    Adjustment of the Pre-Existing Provision – Currently, the ACA doesn’t allow insurers to discriminate against people with pre-existing conditions.   The CARE act will create a one-time enrollment period for individual who lost or lack coverage and those who have been continuously covered for at least 18 months could not be denied coverage or be charged more due to a pre-existing condition.

5)    State Exchanges/Marketplaces would no longer be required but optional under this proposed act. This is a lot easier to say but when you look at the money vested and the adoption rate of the public. This seems to be an issue of an empty threat. The Republicans have beat this drum so many times that they can’t include this type of provision.

All in all, this proposed act gives the Republicans a way to discuss healthcare reform in a different slant. The “repeal Obamacare” didn’t work during the last election and it definitely wouldn’t work today. This puts something new on the plate that, in totality, allows for interesting debate.

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