Don't HR Alone #27 - Senate's ACA Replacement (BCRA) Breakdown
Coverage to age 26:
Stays the same. Dependents remain on there parents plan until age 26, married or not.
Subsidy for purchasing individual health insurance:
The ACA (Obamacare) provided subsidies for those who earned between 132% and 400% of the federal povertly line. If you fell into that category, the cost to your family to purchase the second lowest cost silver plan available in your market is limited to 9.65%.
Under the BCRA, the subsidies are provided for those earning between 0% and 350% of the federal poverty line. Assuming you fall into that category, the cost to your family to purchase a "MEDIAN COST BENCHMARK PLAN", as the law puts it, or in lay mans terms, the cost to your familiy to purchase the average bronze plan available in your area, is limited to a percentage of your income determined by this chart. The chart shows you age on one axis, and the percentage of the federal poverty line on the other.
To help you understand the federal poverty line, here is a table of the 2017 FPL guidelines.
So, for a 40 year old family of four who makes $40,000 per year, your cost for the bronze plan would be 4% of your family income, instead of 9.6% for the second lowest cost silver under the ACA. That sets your subsidy amount, and you can, of course, decide to purchase a more expensive plan, and that same subsidy amount would apply.
So, to summarize, depending on your age, and income level, you could be paying significantly less under the BCRA than under the ACA. Of course, that also means you could pay more.
The way prices are determined by Age:
Another large change is that under the ACA currently, a 64 year old actual rate for insurance, no matter the type of plan, cannot be more than three times the cost of a 21 year old. The BCRA changes that to 5 times. So that means young, probably healthy people, will be charged significantly less, and older people will be charged more. We know the majority of the uninsured are these younger, healthy people. The BCRA argues that they utilize a lot less than 1/5th the services of a 65 year old, and should be charged less so that they will purchase insurance. The general agreement among professionals is that this will result in a lower AVERAGE premium across all ages, but obviously significantly less for young people, and more for older.
Penalties
The BCRAcompletely removes the individual mandate, so people who choose to go uninsured will not face a tax penalty. Under the ACA
The fee for not having health insurance in 2016 & 2017:
The fee is calculated 2 different ways – as a percentage of your household income, and per person. You’ll pay whichever is higher.
Percentage of income
2.5% of household income
Maximum: Total yearly premium for the national average price of a Bronze plan sold through the Marketplace
Per person
$695 per adult
$347.50 per child under 18
Maximum: $2,085
On top of that, the employer penalities for not providing insurance for companies that have more than 50 Full Time Equivalents is also eliminated. Currently, employers are penalized either $2,000 per employee (minus the first thirty) if they do not offer minimum essential coverage. If they do offer coverage, they are penalized $3,000 per person for whom the coverage is "unaffordable," which is 9.5% of their gross pay for employee only coverage.
Again, the BCRA removes all of those penalties.
Medicaid
There are many changes to medicaid in the BCRAvs the ACA, and they are really outside the scope of HR. To summarize, they provide a lot more choice on what is covered and who is covered the individual states, and starting in 2021, provides less money per person than that ACA provided.