Leaked Replacement Plan Reveals What May Be Ahead for Obamacare

House Republicans aim to shrink subsidies, Medicaid expansion

In an exclusive report, Politico has provided a preview of what House Republicans have in mind for the Patient Protection and Affordable Care Act (PPACA), based on a leaked copy of the newly drafted PPACA repeal bill.

The legislation would dismantle the foundation of the controversial health care act, including its individual mandate, cost-sharing subsidies based on people’s income, and all of the law’s taxes, according to the journal. It would also significantly roll back Medicaid spending and give states money to create high-risk pools for some people with pre-existing conditions. Some elements of the repeal would be effective immediately, others not until 2020.

The replacement would be paid for by limiting tax breaks on generous health plans people obtain at work—an idea that is similar to the PPACA’s unpopular “Cadillac tax.”

The Republican plan would also:

  • Eliminate the PPACA’s Medicaid expansion in 2020
  • Provide $100 billion in “state innovation grants” to help subsidize very expensive enrollees
  • Eliminate funding for Planned Parenthood

The proposal also includes penalties for individuals who fail to maintain continuous coverage. If their coverage lapses and they decide to re-enroll, they would have to pay a 30% hike in premiums for one year. Like the PPACA’s individual mandate, that penalty is designed to discourage individuals from waiting until they get sick to obtain coverage.

Lawmakers are still in disagreement about several key issues of the replacement plan, including Medicaid and the size and form of subsidies, the report notes. Discussions within the House, and between House leaders and the White House, about the final proposal are ongoing. President Trump has said he expects a plan to emerge in early to mid March.

“Obamacare has failed,” said Health and Human Services spokesperson Caitlin Oakley. “We welcome any and all efforts to repeal and replace it with real solutions that put patients first and back in charge of their health care rather than government bureaucrats in Washington, D.C.”

Sources: Politico; February 24, 2017; Draft Repeal Bill; February 24, 2017.