Republicans in the United States Senate released their proposed health care reform bill today. (here) It is very similar to the U.S. House bill passed last month. (here)

• Medicaid Expansion – The Senate bill continues funding at the current level for three years, then phases out the expansion over three years. In 2025, overall funding would be tied to a slower growth rate. The House bill ends the expansion in 2020 with no gradual phase out. Both bills give states more flexibility in managing their Medicaid programs.
• Health Insurance Exchanges – Both bills eliminate the exchanges.
• Taxes - Both the Senate and House bills repeal all the Obamacare taxes.
• Mandates - Both bills eliminate the individual and employer mandates.
• Tax Credits - Both bills use refundable tax credits to help people purchase health insurance. The Senate bill ties the amount of credit to age like the House bill, but also uses income as a criteria for credit amount.
• State Control – Both bills gives states more control over their health care delivery systems. The Senate bill specifically uses Obamacare 1332 waivers and allows states to eliminate the insurance benefit mandates with a $2 billion stabilization fund.
• Cost Sharing Reductions – The Senate bill continues these until 2019 to help low-income people purchase insurance in the individual market.
• Stabilization Fund – The House bill provided $138 billion over ten years to stabilize the individual market and allow states to set up high-risk pools for high-use and high-cost patients. The Senate bill provides $50 billion over the next four years for short-term market stabilization. The Senate bill also provides $62 billion over eight years for states to innovate ways of helping low-income and high health care users with pre-existing conditions purchase health care.
• Health Savings Accounts – Both bills provide for an expanded use of health savings accounts.

The next step is the analysis by the Congressional Budget Office. It is anticipated that the Senate will vote on the bill next week before the July 4^th recess.

It is not a comprehensive bill in overturning Obamacare. Like the House bill, however, it is a good start and aligns with the House bill on fundamentals. Democrats seem to be united in voting against the bill. The question is whether the bill satisfies both the conservative and moderate factions of Senate Republicans.