This was already the underlying dynamic of the initial Senate bill.
In their desperation, some Republicans have latched on to a recent amendment introduced by Sens.
The provision would let insurers sell low-priced policies with skimpy coverage, as long as they also sell policies that meet a stringent list of services they're required to provide under Obama's law, like mental health counseling and prescription drugs.
Capito said she continues to be anxious about the bill's original language reducing the amount of federal money states receive if they expanded Medicaid to cover people making just above the poverty line.
A health care proposal from Senate conservatives would let insurers sell skimpy policies provided they also offer a comprehensive plan.
But that incentive to buy comprehensive coverage is far weaker than Obamacare's mandate, which fined people for not having insurance, Jost said.
The measure would also allow companies to take into account people's health status in determining whether to insure them and at what price. Under Cruz's proposal, plans like that would come back to the individual market.
"Junk insurance" refers to health plans boasting low premiums paired with exorbitant deductibles and little to no coverage for care now denoted essential under the ACA.
The herding of all but the healthy into high-risk pools, combined with the repeal of the mandate, guarantees higher premiums, greater uncompensated care and thus higher cost of medical care for everyone. The Senate doesn't provide subsidies to buy unregulated insurance plans, so even if they're healthy, lower-income Americans might be better off buying Obamacare-compliant coverage. This of course is what's happening under Obamacare.
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Whether that funding would be enough to make the plans affordable remains to be seen. Because cutting taxes on the wealthy while slashing Medicaid was a transparent act of class warfare on the poor, the legislation no longer nixes Obamacare's tax on investment earnings or the additional Medicare tax on high earners.
"Policy solutions exist to create more stability in the market by reducing premiums and attracting enrollment of younger and healthier individuals", AHIP said.
"The noncomplying plans would effectively become the whole market", Gamage said.
The office estimated that McConnell's initial bill would have caused 22 million additional people to be uninsured.
Under his proposal, people in good health would have the choice to buy a cheaper plan without the ACA's protections (we'll call this Plan A). But it was only funded with a one-time appropriation of $5 billion, and enrollment was capped at 115,000 before the exchanges opened because the program was running out of money.
The whole thing would function, if it functions at all, like a series of state-based, federally funded high-risk-pools.
Worse, if you're, say, a healthy woman in her 20s or 30s who opts to get a bare-bones plan and then gets pregnant, you can't opt into a new plan until the next open enrollment period.
The Association of Health Insurance Plans (AHIP), the leading industry group, warned in a policy brief of a fractured, unstable market, with skyrocketing premiums for the people most in need of care. And it's people who know more about insurance markets than me who are drawing this conclusion.
"When you create an uneven playing field in health insurance regulation, you create instability", Pollitz said.
According to an analysis by the BlueCross BlueShield Association, major federal consumer protections would not be required for new plans permitted by the Cruz amendment.