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senate Bill S. 191

Sens. Collins's & Cassidy's Plan to Replace Obamacare With the “Patient Freedom Act”

Argument in favor

This Obamacare replacement would empower states to design an alternative that meets their needs and ensure that some of its important consumer protections are preserved, while expanding access to affordable health insurance and giving consumers more options.

michaelB's Opinion
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02/04/2017
This is the better option of the two being discussed. The lesser of two evils I guess. It still looks like nothing is done about reigning in the insurance companies which are the biggest problems. Single payer is the ultimate answer!
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Jason's Opinion
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02/04/2017
Except insurance companies should also be able to compete across state lines as well as consumers being able to purchase insurance in an interstate fashion. We need to make these pools bigger to lower costs.
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brnwaterman's Opinion
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02/05/2017
Healthcare should not be sold to us by the federal government at gunpoint.
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Argument opposed

This bill doesn’t really repeal Obamacare, instead allowing states that like the status quo to keep things the way they are. That doesn’t go far enough, as the health insurance industry needs a complete overhaul and some states keeping things as they are will impede that.

James's Opinion
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02/04/2017
Leave the ACA alone. All it needs is refinement not replacement.
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K's Opinion
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02/04/2017
I vote in North Carolina but I live in Turkey- a country with the fewest number of doctors and nurses per 100,000 people and % of GDP spent on health when compared to other OECD countries. Oh, and it has universal health care. I have seasonal asthma and got the flu on top of it which led to a visit to the ER because I couldn't breathe. Wait time: less than 2 minutes. 10 minute examination, total blood work up, chest-X-ray, IV drip with drug, oxygen mask with drug. Total cost: $7.82 (30 Lira at today's rate). Get with the program America.
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Ashley's Opinion
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02/04/2017
Repair ACA! Do not replace with something that benefits insurance companies more than it does the individuals it covers!
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What is Senate Bill S. 191?

This bill — known as the Patient Freedom Act of 2017 — would look to replace Obamacare by preserving some portions of the law and repealing others and giving states the option of keeping their exchanges or developing a new alternative. It would repeal the individual and employer mandates, the requirements that healthcare plans fit into four categories, age requirements that drive up prices for the young, and benefit mandates. It would keep certain consumer protections, like the prohibition on excluding people with pre-existing conditions, letting individuals stay on their parents’ plan until they’re 26, and preserving coverage for mental health and substance abuse disorders.

States would be able to choose one of three options:

  • Reimplement the ACA: States could reinstate Obamacare’s mandates and other requirements. Under this option they’d be able to continue receiving federal premium tax credits, cost-sharing subsidies, and Medicaid dollars as long as those subsidies don’t exceed the contributions that’d be made under the second option.

  • Choose a New State Alternative: States could enact a new market-based system that empowers patients while still protecting those with pre-existing conditions. It could continue to receive funding equal to 95 percent of federal premium tax credits and cost-sharing subsidies plus the federal Medicaid match. They could receive funds in the form of beneficiary grants or advanceable, refundable tax credits — but in both cases funds would go directly to the patient by being deposited into a Roth Health Savings Account.

  • Design an Alternative Without Federal Assistance: States could choose to design and regulate insurance markets that work for their specific populations without any federal assistance.

Impact

People who have or acquire health insurance; employers; health insurance providers; states; and the federal government.

Cost of Senate Bill S. 191

A CBO cost estimate is unavailable.

More Information

In-Depth: Sponsoring Sen. Bill Cassidy (R-LA) introduced this bill to replace Obamacare while giving states the option of reinstating the law’s mandates or designing their own alternative with or without federal assistance:

“We have been stressing the importance of making sure we have a replacement plan ready to go with the repeal of Obamacare, in order to ensure that no one sees a gap in their health care coverage. With the introduction of the Patient Freedom Act of 2017, I believe we now have that plan. President Trump has said that he wants to have health care coverage for all under the replacement plan. The Patient Freedom Act does this and more.”

Detractors have criticized this bill for allowing too much of Obamacare to live on if states choose to keep it. In the Washington Examiner, Philip Klein called it “Obamacare Forever” because it keeps taxes and spending in place, along with the federal insurance exchanges. Klein also said that the federal regulations that would remain intact, including those for preexisting conditions and letting adults up to age 26 remain on their parents’ plans, which would mean “any state that opts out of Obamacare would continue to be restricted by its regulatory tentacles.”

This legislation has the support of three additional Republican cosponsors in the Senate aside from Sen. Susan Collins (R-ME), including Sens. Shelley Moore Capito (WV), Johnny Isakson (GA), and Lindsey Graham (SC).


Media:

Summary by Eric Revell

(Photo Credit: Medill DC / Creative Commons)

AKA

Patient Freedom Act of 2017

Official Title

A bill to improve patient choice by allowing States to adopt market-based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care.

bill Progress


  • Not enacted
    The President has not signed this bill
  • The house has not voted
  • The senate has not voted
      senate Committees
      Committee on Finance
    IntroducedJanuary 23rd, 2017
    This is the better option of the two being discussed. The lesser of two evils I guess. It still looks like nothing is done about reigning in the insurance companies which are the biggest problems. Single payer is the ultimate answer!
    Like (79)
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    Leave the ACA alone. All it needs is refinement not replacement.
    Like (111)
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    I vote in North Carolina but I live in Turkey- a country with the fewest number of doctors and nurses per 100,000 people and % of GDP spent on health when compared to other OECD countries. Oh, and it has universal health care. I have seasonal asthma and got the flu on top of it which led to a visit to the ER because I couldn't breathe. Wait time: less than 2 minutes. 10 minute examination, total blood work up, chest-X-ray, IV drip with drug, oxygen mask with drug. Total cost: $7.82 (30 Lira at today's rate). Get with the program America.
    Like (93)
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    Repair ACA! Do not replace with something that benefits insurance companies more than it does the individuals it covers!
    Like (80)
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    You can't eliminate the mandates and keep prices affordable. And tax credits are worthless to the working poor who are least likely to be covered but can't take advantage of them. Health savings accounts? More nonsense. Is there a reason I'm missing why Republicans prefer Americans to be sick?
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    Absolute nonsense! We are still seeing plans that do not address the key goals of ACA, including reducing the number of the uninsured and reducing the overall costs of healthcare. Either fix the bugs in ACA to improve it, or replace it with a single payer system of Universal Healthcare. Let's join the civilized world, including developing nations and raise the living standards of our people through universal or near universal access to affordable and quality healthcare.
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    Except insurance companies should also be able to compete across state lines as well as consumers being able to purchase insurance in an interstate fashion. We need to make these pools bigger to lower costs.
    Like (22)
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    The health insurance industry and our system is broken. Until we can put a single payer system in place, patch up the ACA and while we are at it, REQUIRE that ALL members of Congress must participate in the system created for the citizenry. I cannot think of any better way to ensure a fair and workable system than if our leaders had to participate in the plan. After all, good leaders do not ask their followers to do something they themselves are not willing to do. Is this not a principle that both liberals and conservatives can rally around? What is wrong with asking Congress to drink their own medicine?
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    Keep the ACA but strengthen and improve. However single payer system would be better.
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    I like the repeals of this bill. A lot of it is in the right direction. But keeping the preexisting condition clause is a huge factor in what makes health insurance so much more expensive. Look, I hate the cosmic injustice done to someone who has gotten cancer. That really sucks. But I don't think the answer is to then do injustice to someone else. The insurance company is in the business of taking on risk in exchange for money. That's what any insurance company does. You pay them to take your risk. For life insurance they take your risk of death, for car insurance they take your risk of a crash, for homeowner's insurance they take your risk of a tree falling on your house, and for health insurance they take the healthy person's risk of getting sick. If you've already gotten sick, though, you don't have any risk for them to take. Now you're looking for someone to take on the burden of your payments, and I get that. But they're not in the business of taking on payments. They're in the business of taking on risk, and you sadly have none to give. And that is a really terrible situation, but it doesn't justify forcing someone else to pay for you, especially when paying for sick people is not even the business they're in in the first place. Repealing everything else is the right direction, but leaving this key provision in place will actually make things worse. It would be better to just repeal the whole thing. I prefer Senator Rand Paul's plan because it is a more sweeping replacement of the ACA with the type of free market reforms we need.
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    It appears to me as a "Fresh Coat of Paint" for ObamaCare. This may help the appearance of a cracked and damaged wall, but it's still the same wall. These Senators are using Obamathink like lipstick on a pig analogy. We as taxpayer's didn't like it under Obama and we still want to lead this pig to slaughter.
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    Healthcare should not be sold to us by the federal government at gunpoint.
    Like (11)
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    As Senator Rand Paul stated: "Prior to the implementation of Obamacare, our health care system was over-regulated and in need of serious market reforms — and ObamaCare has only made it worse. Government interventions in health care have driven up the cost of coverage and decreased competition within the market. More — not less — freedom to choose and innovate will make sure our health care system remains the best in the world." True patient freedom would be the ability to purchase health insurance across state lines and the ability to see ANY physician that we choose! I agree with what Countable member Michael said: "Susan Collins is a RINO whose bill provides MORE federal funding for abortion than Obama's!!! Besides, you know if Lindsey "Big Government Neocon" Graham is cosponsoring, there isn't a hint of fiscal responsibility to the bill."
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    This seems to make an already complex situation even more complex, since each state could handle it differently. I'd like to see us simplify things.
    Like (9)
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    This just isn't good enough period.
    Like (8)
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    This bill offers no workable alternative to the present ACA. What we need to do is modify the ACA to better meet the needs of all Americans, to provide reasonably priced healthcare for all Americans, to decrease the costs of healthcare services and equipment, to permit the federal government to negotiate with Big Pharma and all providers using the entire American population as the pool of insureds so we can better control the costs of drugs and procedures, and redesign the way care is provided so that those who actually provide the care are appropriately compensated and the insurance middle men are taken out of the picture. Insurance is for cars and other property, or personally chosen for meeting needs of surviving family of deceased persons. It is not for healthcare! Every citizen of a country has a right to access reasonable healthcare services without ending up in the poor house!
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    For starters there's not even a cost estimate. The only answer is a single payor system.the fact that Aetna bowed out of exchanges to try for a better share price for merger with humana shows us that as long as insurance is free market , profits will always come first and the insured will come last.
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    Why not go for something better like a single payer system instead?
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    Repeal of the entire system is an incredible waste of money. Work with the system that is in place to provide more options and resources for the public. What a waste to throw away a system that took millions of dollars - there are improvements and changes that can be made without dismantling the entire thing. Also, the Affordable Care Act made incredible advances to protect against insurance fraud. It also provided coverage for basic screenings, women's health care, and children's checkups that pave the way for prevention and improvement of public health. We need to preserve these provisions, not dismantle the entire thing and start over!
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    Don't replace the ACA, fix what needs fixing, but leave the bulk of it alone, it is working and has many protections in place!!!!
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