Two Very Different Healthcare Bills, Two Very Different Outcomes for Your Family

As Republicans make one last effort to repeal and replace Obamacare before a September 30th deadline, Democrats introduce a single-payer system to the mix.

Medicare for All
Photo: Jim Watson/Getty Images

It's clear that consensus around healthcare may be hard to come by in Washington right now. The Republicans are pushing a third attempt to repeal and replace the Affordable Care Act with the Graham-Cassidy Amendment, which would nix key provisions in Obamacare. And the Democrats released their own plan, called Medicare for All, which would set up a single-payer system that provides healthcare for everyone. So what's behind these two bills?

Graham-Cassidy Bill

Senators Lindsey Graham and Bill Cassidy created this bill, which is the Republicans' last-ditch effort to repeal and replace Obamacare before a September 30th deadline—after which they would need 60 votes in order to pass healthcare legislation, instead of a simple majority.

Here's what you can expect with the new plan:

No more healthcare subsidies.

• People with preexisting conditions may not have their condition covered or may be charged higher premiums. For those with preexisting conditions, this new law would allow states to decide whether insurers in that state could exclude coverage of the conditions in their policies, or charge higher premiums for people with preexisting conditions.

Significant cuts to not only the Medicaid expansion that happened with Obamacare, but people who received Medicaid before the Affordable Care Act.

The creation of block grants the states could use as they choose to bolster their citizens' healthcare. The amount given to each state would be determined by a formula that factors in the cost of living, but would also reduce benefits for states that already pay significant amounts for their citizens' healthcare. However, these grants will only be in place until 2026—after that, the effect will be similiar to simply repealing without replacing Obamacare.

No more penalties for failing to buy coverage. Experts say change will increase the price of insurance for everyone who decides to purchase it, as healthier people may decide not to buy insurance without the penalties.

Employers no longer have to provide health insurance to their employees.

Kids can stay on their parents' insurance until they turn 26.

Health insurers will receive $155 billion to cover losses caused by the new law.

Planned Parenthood cannot receive Medicaid funds for the next year.

The new bill has not yet been scored by the Congressional Budget Office, though experts expect that it will have similar results as a repeal-without-replace scenario—in other words, they expect that nearly 32 million Americans will lose health coverage over the next decade if this bill is passed.

Medicare for All

The Democratic plan, introduced by Senator Bernie Sanders and some of Capitol Hill's most progressive members, including Senators Kamala Harris, Cory Booker, Elizabeth Warren and Kirsten Gillibrand, would expand Medicare gradually to cover all Americans. Here's what's in that plan:

Medicare rolls out over several years, starting with the elderly and children.

• Everyone would eventually be covered, for dental, vision, and medical benefits.

It would be paid for either through an employer tax or by paying income-adjusted taxes to the government. Lower income families would owe nothing, while those making the most money would pay more. Since families would no longer need to pay premiums for private health insurance, that would be expected to balance out the cost of the new taxes.

Unlike Medicare now, the new plan would allow the government to negotiate drug prices with pharmaceutical companies. Experts expect that could significantly lower healthcare costs.

What Will Happen Next?

Senate Majority Leader Mitch McConnell is planning to bring the Cassidy-Graham bill to a vote as early as September 27th. They are currently awaiting a score from Congressional Budget Office, and working to get the votes from Senators. Already, Senator John McCain, whose dramatic vote killed the last Senate attempt to replace the Affordable Care Act, has expressed support for this new measure.

As for the Medicare for All act? It likely won't become law in the current political landscape.

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