Option #1:
Let states keep A.C.A. as is
Option #2:
Alternative plan with federal funding
Option #3:
Alternative plan with no federal funding
Individual mandate
Repeal
Repeal
The Affordable Care Act (A.C.A.) requires people who can afford it to obtain health insurance or face tax penalties. This is a critical part of the law that keeps insurance affordable for those who are older or sick.
This option repeals the individual mandate and instead allows states to auto-enroll uninsured individuals in basic coverage. This would bring more healthy people into the market to keep insurance affordable for those who are older or sick.
The individual mandate would be repealed, and states choosing this option would not auto-enroll the uninsured.
Employer mandate
Repeal
Repeal
Under the A.C.A., larger companies must provide affordable insurance to their employees or face financial penalties.
Subsidies
Change
Repeal
Under the A.C.A., the federal government provides tax credits to some individuals, generally those making under 400 percent of the federal poverty level, to help offset the cost of premiums and deductibles. States choosing this option would get 95 percent of the funding they would have received under the A.C.A.
The federal government would pay states 95 percent of the funding they would have received for subsidies under the A.C.A. States would receive the money as grants or tax credits, and the money would be deposited into patients' health savings accounts to pay for health insurance.
The federal government would provide no funding.
Medicaid expansion
Keep
Repeal
Under the A.C.A., more than 30 states expanded Medicaid coverage by raising the eligibility cutoff to 138 percent of the poverty level.
States that expanded Medicaid eligiblity would continue to receive federal funding and could also use the money as subsidies to help individuals buy private insurance. Additional states could expand Medicaid and use the funds in either way.
The federal government would provide no funding.
Pre-existing conditions policy
Change
Change
The A.C.A. requires insurance companies to cover people, regardless of pre-existing medical conditions, and bars them from charging more based on a person's health history.
States would be required to keep this provision for people who stay insured, or people who enroll in basic coverage even after letting their coverage lapse. However, customers who don't maintain continous coverage could be charged higher prices for more robust plans, as well as enrollment penalties, if they have a history of medical conditions.
Even states not receiving any federal funding would be required to keep this provision for people who maintain insurance coverage. But customers who let their insurance coverage lapse could be charged higher prices for some plans if they have a history of medical conditions.
Restrictions on charging more for older Americans
Repeal
Repeal
Under the A.C.A., plans can only charge their oldest customers three times the prices charged to the youngest ones.
Essential health benefits
Keep just one.
Keep just one.
Under the A.C.A., all insurers must offer 10 essential health benefits, including maternity care and preventive services.
States would be required to keep coverage only for mental health and substance use disorder.
States would be required to keep coverage only for mental health and substance use disorder.
Prohibitions on annual and lifetime limits
Keep
Keep
The A.C.A. bars insurers from setting any limit on how much they have to pay to cover someone.
States would be required to keep this provision.
Even states not receiving any federal funding would be required to keep this provision.
Dependent coverage until 26
Keep
Keep
Under the A.C.A., children can stay on their parents' insurance policies until age 26.
Individual mandate
Under A.C.A.
The Affordable Care Act (A.C.A.) requires people who can afford it to obtain health insurance or face tax penalties. This is a critical part of the law that keeps insurance affordable for those who are older or sick.
Plan with federal funding
Repeal
This option repeals the individual mandate and instead allows states to auto-enroll uninsured individuals in basic coverage. This would bring more healthy people into the market to keep insurance affordable for those who are older or sick.
Plan without federal funding
Repeal
The individual mandate would be repealed, and states choosing this option would not auto-enroll the uninsured.
Employer mandate
Under A.C.A.
Under the A.C.A., larger companies must provide affordable insurance to their employees or face financial penalties.
Plan with federal funding
Repeal
Plan without federal funding
Repeal
Subsidies
Under A.C.A.
Under the A.C.A., the federal government provides tax credits to some individuals, generally those making under 400 percent of the federal poverty level, to help offset the cost of premiums and deductibles. States choosing this option would get 95 percent of the funding they would have received under the A.C.A.
Plan with federal funding
Change
The federal government would pay states 95 percent of the funding they would have received for subsidies under the A.C.A. States would receive the money as grants or tax credits, and the money would be deposited into patients' health savings accounts to pay for health insurance.
Plan without federal funding
Repeal
The federal government would provide no funding.
Medicaid expansion
Under A.C.A.
Under the A.C.A., more than 30 states expanded Medicaid coverage by raising the eligibility cutoff to 138 percent of the poverty level.
Plan with federal funding
Keep
States that expanded Medicaid eligiblity would continue to receive federal funding and could also use the money as subsidies to help individuals buy private insurance. Additional states could expand Medicaid and use the funds in either way.
Plan without federal funding
Repeal
The federal government would provide no funding.
Pre-existing conditions policy
Under A.C.A.
The A.C.A. requires insurance companies to cover people, regardless of pre-existing medical conditions, and bars them from charging more based on a person's health history.
Plan with federal funding
Change
States would be required to keep this provision for people who stay insured, or people who enroll in basic coverage even after letting their coverage lapse. However, customers who don't maintain continous coverage could be charged higher prices for more robust plans, as well as enrollment penalties, if they have a history of medical conditions.
Plan without federal funding
Change
Even states not receiving any federal funding would be required to keep this provision for people who maintain insurance coverage. But customers who let their insurance coverage lapse could be charged higher prices for some plans if they have a history of medical conditions.
Restrictions on charging more for older Americans
Under A.C.A.
Under the A.C.A., plans can only charge their oldest customers three times the prices charged to the youngest ones.
Plan with federal funding
Repeal
Plan without federal funding
Repeal
Essential health benefits
Under A.C.A.
Under the A.C.A., all insurers must offer 10 essential health benefits, including maternity care and preventive services.
Plan with federal funding
Keep just one.
States would be required to keep coverage only for mental health and substance use disorder.
Plan without federal funding
Keep just one.
States would be required to keep coverage only for mental health and substance use disorder.
Prohibitions on annual and lifetime limits
Under A.C.A.
The A.C.A. bars insurers from setting any limit on how much they have to pay to cover someone.
Plan with federal funding
Keep
States would be required to keep this provision.
Plan without federal funding
Keep
Even states not receiving any federal funding would be required to keep this provision.
Dependent coverage until 26
Under A.C.A.
Under the A.C.A., children can stay on their parents' insurance policies until age 26.
Plan with federal funding
Keep
Plan without federal funding
Keep
The New York Times