This post was written by Connor Balough
After weeks of waiting — and 8 years of hoping — House Republicans on Monday released their proposal to repeal the Affordable Care Act. It’s called The American Healthcare Act.
Elements of the proposal, which was kept under lock and key last week — have been leaked out for a few days. The text of the two bills encompassing the GOP plan validates much of what we gleefully expected. On the whole, however, it’s a friendlier, more working American-friendly proposal than even a lot of conservatives expected.
The proposal defunds Planned Parenthood. No federal funding can be made, either directly or indirectly, by Medicaid to a healthcare organization that “provides for abortions,” other than those done in cases of rape or incest or to save the life of the mother. That’s Planned Parenthood. It’s proper to note that Planned Parenthood has come out vocally against this, claiming they don’t use federal money to pay for abortions, and that it’s already against the law. But this measure shuts down funding for an organization that is performing abortions and able to sustain it’s existence on taxpayers’ backs.
The bill effectively shuts down private health insurance coverage for abortion. According to a House Ways and Means Committee digest, the measure forbids spending federal tax subsidies on health plans that include coverage of abortion, even if the customer doesn’t get an abortion. would limit availability for abortions, or would lead to insurers dropping abortion coverage from their plans, or both. Customers could buy separate policies to cover abortions, but couldn’t use the federal subsidy to help pay for them. Insurers likely would charge hugely discouraging premiums for such policies, as the market for them would be tiny.
The individual and employer mandates are eliminated. They’re not repealed exactly, but the penalties are repealed, which amounts to the same thing. This is the death blow to Obamacare, and what was driving premiums so high for consumers. Aetna’s chairman and chief executive, Mark Bertolini, said recently that the individual market was entering a “death spiral” in which healthier customers dropped coverage, leaving sicker customers who know they need insurance facing an ever-increasing rates.
Bertolini’s remarks at the Wall Street Journal’s the Future of Healthcare event came a day after the official end of his company’s proposed merger with the health insurer Humana — a divorce that will cost Aetna a $1 billion breakup fee. It also came a day after Humana announced that it would pull out of all of its remaining ACA exchanges for 2018, arguing that the risk pool was unbalanced because not enough healthy people were signing up for insurance compared with the number of sick people.
“That logic shows just how much the risk pool is deteriorating in the ACA and how poorly structured the funding mechanism and premium model is,” Bertolini said. “I think you will see a lot more withdrawals this year of plans.”
All of Obamacare’s taxes are repealed, another relief for working class. Everything from the tax on tanning salons and medical devices to the surcharge on taxpayers will be gone. As we explained earlier, this amounts to an enormous tax break for Americans — at least $346 billion over 10 years. The proposal would greatly lower and even reverse some of the Obama inflation we’ve seen in the past 8 years.
It will Help Americans access affordable, quality health care by providing a monthly tax credit—between $2,000 and $14,000 a year—for low- and middle-income individuals and families who don’t receive insurance through work or a government program.
Here’s some of the common questions answered from the House GOP website on the bill:
What does your legislation do?
Our plan delivers relief from the taxes and mandates that have hurt job creators, increased premiums, and limited options for patients and health care providers.
It returns control of health care from Washington back to the states and restores the free market so Americans can access the quality, affordable health care options that are tailored to their needs.
How will your legislation be better than Obamacare?
Obamacare was based on a one-size-fits-all approach that put bureaucrats in Washington in charge of your health care.
The law led to higher costs, fewer choices, and less access to the care people need.
What we’re proposing will deliver the control and choice individuals and families need to access health care that’s right for them.
And we provide the freedom and flexibility states, job creators, and health care providers need to deliver quality, affordable health care options.
How will this improve my health care?
What we’re proposing will decrease premiums and expand and enhance health care options so Americans can find a plan that’s right for them.
We also make sure Americans can save and spend their health care dollars the way they want and need—not the way Washington prescribes.
Are you repealing patient protections, including for people with pre-existing conditions?
No. Americans should never be denied coverage or charged more because of a pre-existing condition.
We preserve vital patient protections, such as (1) prohibiting health insurers from denying coverage to patients based on pre-existing conditions, and (2) lifting lifetime caps on medical care.
And we allow dependents to continue staying on their parents’ plan until they are 26.
Are you repealing all of Obamacare’s taxes?
Our plan delivers relief from all of Obamacare’s taxes, including dismantling taxes on prescription drugs, over-the-counter medications, health-insurance premiums, and medical devices.
And we immediately eliminate the individual and employer mandate penalties, which forced millions of people into Obamacare plans they don’t want and cannot afford.
Are you repealing the subsidies?
Obamacare’s subsidies must be repealed. They are deeply flawed and leave millions of middle-class individuals and families without any help to pay for health care.
Just as President Trump called for, we will replace Obamacare’s subsidies with a tax credit that helps Americans—including those Obamacare left behind—access health care options that are tailored to their needs.
Are you repealing Obamacare’s Medicaid expansion?
Medicaid is a critical program, but it has its flaws—including fewer choices and less access to quality care. Obamacare’s expansion made those flaws worse.
Our proposal strengthens Medicaid and targets the program’s limited resources to the patients most in need.
We will provide a stable transition and help ensure low-income Americans have access quality, affordable options through a new, competitive, state-based private insurance marketplace.
Won’t millions of Americans lose their health insurance because of your plan?
No. We are working to give all Americans peace of mind about their health care. We will have a stable transition toward a system that empowers patients with more choices and lower costs.
During the transition, Americans will continue to have access to their existing health care options.
We even take steps to immediately provide more flexibility and choice for the people who purchase insurance through the individual marketplace. For example, individuals and families will be able to use their existing subsidy to purchase insurance—including the catastrophic coverage that’s currently prohibited—off of the exchanges.
What happens to the coverage I get through work?
We preserve employer-sponsored coverage—a vital benefit that helps more than 150 million workers and families access affordable, quality health care.
How are you going to cover the millions of Americans who gained coverage through Obamacare’s Medicaid expansion?
Our proposal provides Americans who do not receive insurance through work or a government program with an advanceable, refundable tax credit so they can access a plan that’s right for them—not one that’s dictated by Washington.
How is this tax credit different than Obamacare’s subsidies?
Obamacare’s subsidies were based on income, created a disincentive to work, and left millions of hard-working, middle-class Americans behind.
Obamacare’s subsidies also only applied to insurance dictated by Washington, substantially limiting flexibility and choice.
Our legislation repeals Obamacare’s flawed subsidies in 2020 and instead provides a tax credit to low- and middle-income Americans who do not receive insurance through work or a government program.
Unlike Obamacare’s subsidies, these tax credits are based on age and family size and will gradually phase out as your income increases—making sure work always pays and hard-working Americans are never left behind.
How big will my tax credit be? Will I be able to buy a real health care plan with it?
Our tax credits are based on age and family size.
Each year, low- and middle-income Americans will be eligible to receive between $2,000 and $14,000 to purchase health insurance, depending on how old you are and how big your family is.
These tax credits will be credible—something that will make a meaningful difference for individuals and families when it comes accessing health care through a new, competitive, state-based insurance market.
With all the other policies, we are proposing to increase choices and lowers costs, this tax credit will help people access the health care options they want and need.
How will women be affected under your proposal?
Our proposal specifically prohibits any gender discrimination.
Women will have equal access to the same affordable, quality health care options as men do under our proposal.
Will women be able to purchase a plan that covers abortions?
No. Our proposal is consistent with the bipartisan Hyde Amendment, which does not allow taxpayer dollars to go toward funding an elective abortion.
Won’t premiums increase when you repeal the individual and employer mandates because fewer people will participate in the individual market?
By repealing taxes, rolling back regulations and mandates, and restoring control back to the states, our plan unleashes innovation and competition in the health care.
This approach will result in lower costs and more choices. In fact, our plan is expected to lower premiums. And it will deliver much more flexibility for people to save and spend their health care dollars the way they want and need.
How are you paying for this plan? How much is it going to cost taxpayers?
We are still discussing details, but we are committed to repealing Obamacare and replacing it with fiscally responsible policies that restore the free market and protect taxpayers.