Jul 13, 2017

Draft GOP health bill will include Cruz provision

J. Scott Applewhite / AP

A controversial idea championed by Sen. Ted Cruz will be included in today's draft of the GOP health care bill, according to three sources familiar with the bill. It's similar to the provision Cruz worked on with Sen. Mike Lee, but Lee hasn't seen the bill yet and is not yet sure whether he supports it, according to his office.

  • The Consumer Freedom Option allows insurers selling plans compliant with Affordable Care Act regulations to also sell non-compliant plans. The provision will be in brackets, the sources say, meaning it's incomplete and subject to edits or removal. However, the Congressional Budget Office is still analyzing two versions of the bill, one with the provision and one without.
  • Why this matters: Critics say this would undermine consumer protections like the ACA's essential health benefits and ban on charging sick people higher premiums. That's because healthy people will likely choose noncompliant plans, while sick people will keep plans with more protections for them, fragmenting the market and raising premiums for those with pre-existing conditions. Supporters of the idea say sick people will be insulated from higher premiums by subsidies and the bill's stabilization fund.
  • What we're watching: The majority of industry and consumer groups have come out against the provision, as have many moderate Republicans. The provision may not survive the intense criticism it's about to get. It also may not comply with Senate budget rules, which will be determined sometime before the bill goes to the floor.

Here's what else know will be in the revised bill, per a Senate GOP leadership summary:

  • An additional $70 billion to help states stabilize their markets and offset the costs of covering expensive patients — on top of more than $100 billion that was already there.
  • $45 billion to fight the opioid epidemic.
  • A provision allowing people to use tax-preferred health savings accounts to pay their premiums
  • Changes to the ACA that would let more consumers use tax subsidies to buy plans that only offer catastrophic coverage.
  • The bill would no longer repeal two of the ACA's tax increases on wealthy families, and it won't include a new tax break for health-care executives.
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