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.