The least you need to know about the Senate healthcare bill

Whether the Senate version of health reform policy that was released as a draft today is a viable option will be decided by Congress as early as next week. Here is the least you need to know.

The Senate draft at the moment:

• Converts federal Medicaid funding to defined contribution, flat-rate models, which experts say will result in substantial cuts to services and enrollment.
• Phases out Medicaid expansion over four years, beginning in 2020.
• Allows states to impose work requirements on certain populations signing up for Medicaid.
• Allows for $2 billion in grants in 2018 for efforts to combat the opioid crisis.
• Allows states to design their own programs—as the Affordable Care Act (ACA) did—but takes away the requirement that new designs cover the same amount of people or reduce costs.
• Allows states to permit plans to end essential health benefits, including mental health and substance use disorder coverage.
• Effectively ends the individual and employer mandates.
• Tweaks the IMD exclusion to allow 30 days of treatment but does not eliminate it entirely.
• Will allow health plans to charge older people higher premiums.
• Retains the ACA rule that allows children to stay their parents’ plans until age 26.
• Retains the pre-existing condition provision, but adds a continuous coverage stipulation.
• Allows for health plans with lower levels of coverage (58% actuarial value).
• Cuts a number of taxes, including the tax on medical devices and tanning salons.
• Currently does not have a score from the Congressional Budget Office.
• Only requires 50 votes to pass, or in the event of a tie, a tie-breaking vote from Vice President Pence.

Four senators said on Thursday that they were not in favor of the bill as is or are not in favor of voting on the bill so soon: Rand Paul (R-Ky.), Ted Cruz (R-Texas), Ron Johnson (R-Wisc.) and Mike Lee (R-Utah).