Republicans have finally announced their plan to repeal and replace the Patient Protection and Affordable Care Act (PPACA), rejecting the mandate for most Americans to have health insurance in favor of a new system of tax credits to induce people to buy insurance on the open market. Not surprisingly, Democrats greeted the package with angry protests.
“Republicans will force tens of millions of families to pay more for worse coverage––and push millions of Americans off of health coverage entirely,” said Representative Nancy Pelosi (D-California), the Democratic leader and a staunch supporter of Obamacare.
The House Republican bill would roll back the expansion of Medicaid that has provided coverage to more than 10 million people in 31 states, reducing federal payments for many new beneficiaries, according to an article in The New York Times. It also would scrap the unpopular requirement that people have insurance and eliminate tax penalties for those who go without it. The requirement for larger employers to offer coverage to their full-time employees would also be eliminated.
People who let their insurance coverage lapse, however, would face a significant penalty. Insurers could increase their premiums by 30%, and in that sense, Republicans would replace a penalty for not having insurance with a new penalty for allowing insurance to lapse, according to the Times.
The plan would also provide states with $100 billion to create programs for patient populations, possibly including high-risk pools to provide insurance to the sickest patients.
Moreover, the measure would cut off federal funds to Planned Parenthood clinics through Medicaid and other government programs for one year.
House Republican leaders said they would keep three popular provisions in the PPACA: the prohibition on denying coverage to people with pre-existing conditions; the ban on lifetime coverage caps; and the rule allowing young people to remain on their parents’ health plans until age 26.
Two House committees—Ways and Means and Energy and Commerce—plan to take up the legislation on Wednesday, March 8. House Republicans hope the committees will approve the measure this week, clearing the way for the full House to act on it before a spring break scheduled to begin on April 7, the Times says.
The fate of the plan is uncertain, however, even with Republican majorities in both chambers, according to a Reuters report. Also unclear is where President Trump stands on many of the details.
Just before the plan was unveiled, four moderate Senate Republicans signed a letter saying that an earlier draft of the repeal bill would not adequately protect people in states like theirs that had expanded Medicaid under the PPACA.
In addition, three conservative Republicans in the Senate—Mike Lee of Utah, Rand Paul of Kentucky, and Ted Cruz of Texas—have expressed reservations about the House’s approach.
Representative Mark Meadows (R-North Carolina), chairman of the conservative House Freedom Caucus, joined Paul in urging Republican leaders to pursue a “clean repeal” of the PPACA.
“Conservatives don’t want new taxes, new entitlements, and an ‘ObamaCare Lite’ bill,” they wrote on the Fox News website. “If leadership insists on replacing ObamaCare with ObamaCare Lite, no repeal will pass.”