On January 23, Republican Senators Bill Cassidy (R-LA) and Susan Collins (R-ME) held a press conference to discuss aspects of an Affordable Care Act (ACA) replacement bill they have drafted. The Patient Freedom Act (S. 191) was introduced on the Senate floor, but the Senators said that the legislation is still very much a “work in progress”. The bill would give states a variety of options: 1) to opt out of federal programs, 2) keep the ACA, or 3) permit uninsured individuals to opt-out of automatic enrollment in the replacement plan. A standard plan under this replacement would have high deductibles and be financed with a Health Savings Accounts (HSA) for individuals. The HSAs would be pre-funded with an advanceable tax credit, with a subsidy phase out based on income level. It would also include pharmacy benefits and a catastrophic care benefit.
Representative Pete Sessions (R-TX) is the sponsor for a companion bill in the House. The bill is a first step in proposing concrete ideas for an ACA replacement bill. It is likely to undergo significant revisions as Republican lawmakers continue to grapple with what the replacement bill should look like in final form.