We finally have a more comprehensive idea of the Republican plan to repeal and replace the Affordable Care Act, the law better known as Obamacare.
Politico’s Paul Demko released a draft Friday of the reconciliation bill designed by House Republicans that would repeal and replace the ACA.
The draft bill includes provisions repealing large swaths of the ACA, from Medicaid expansion to the penalty for Americans that don’t purchase health insurance. And it calls for shifting payments for expanded coverage to more block-style grants for both individuals and state governments.
Here’s a quick rundown of the key parts of the draft bill:
- Penalizes those that have a lapse in health coverage: A person that goes without health insurance for a period of time will face a premium penalty up to 30% above the baseline. This is likely designed to encourage people to sign up for care without a mandate.
- Shifts tax subsidies to block grants based on age: Instead of tax subsidies based on income, as in the ACA, the House GOP plan would give every American a chunk of money to purchase insurance based on their age. The lowest amount would be for people under 30, who would receive $US2,000 annually.
- Eliminate Medicaid expansion by 2020: Currently, the federal government provides states funding to expand Medicaid, the government program that provides insurance for low-income Americans. The bill would end that level of funding in 2020 and begin to provide lower amounts to states if they wish to continue covering people who have gained access to Medicaid under the ACA. Many Republican governors and senators do not want Medicaid expansion repealed.
- Provide funding to states to establish high-risk pools and increase coverage: The federal government would provide a total of $US15 billion in 2018 and 2019 and $US10 billion each year through 2026 for “State Innovation Grants” for things like “covering high-risk individuals,” “stabilizing premiums” in the individual insurance market, and “promoting access to preventative services.”
- Allow states to determine “essential health benefits”: Currently, the ACA has a list of benefits that must be covered by a plan on the exchanges to qualify for a metal level. The House bill would allow states to instead determine those essential benefits starting in 2020.
- Change the age band for cost of coverage: Currently, the ACA says premiums for elderly people can only be three times the cost of those for young people. The new plan would change that to five times.
House Speaker Paul Ryan said in a press conference earlier this month that the plan was awaiting scoring from the Congressional Budget Office and the Joint Committee on Taxation. He also said the law should be introduced after Congress’ current week-long break.
The bill has not yet been named.
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