NCPA - National Center for Policy Analysis

The Burr-Hatch-Upton Plan v. The Affordable Care Act

March 31, 2015

The Patient Choice, Affordability, Responsibility and Empowerment Act (Patient CARE) is a bill drafted by Republican Senators Richard Burr (R-NC) and Orrin Hatch (R-UT) that seeks to change the Medicaid program through various methodologies, which are in strong contrast to the Affordable Care Act (ACA).

Major changes outlined by the new plan include:

  • Making states responsible for insurance regulation rather than the federal government, while preventing patients with preexisting conditions from being denied given they are always enrolled in a health plan
  • Inflation-adjusting tax credits would provide additional assistance to workers in small firms, the elderly and people living below 200 percent of the federal poverty level
  • Federal tax credits available to individuals would allow them to purchase insurance with private entities rather than through Medicaid

The Center on Health and Economy provided its own estimates on the health and financial consequences of successfully passing the Patient CARE Act:

  • Premium costs could be released by almost as much as 20 percent, a strong advantage in states that are looking to enroll younger, healthier adults in healthcare plans.
  • A net effect where slightly over 3 million people more are uninsured relative to projections by the ACA.
  • Cost-cutting activities by employers would be reduced by a repeal and replacement of the Cadillac tax with the tax exclusion cap, and families who are beneficiaries from the new cap could see their incomes rise by as much as $2,500.

Republicans will be listening to King v. Burwell very closely, no doubt. If the plaintiffs succeed in overturning ACA's health insurance subsidies, it could pave the way for the Patient CARE Act to be inaugurated as a viable alternative to many ACA mandates.

Source: Joseph Antos and James Capretta, "Unpacking The Burr-Hatch-Upton Plan," Health Affairs, March 30, 2015.  


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