Outline of GOP plan to replace ACA has few surprises

Dive Brief:

  • An outline of the Republican plan to replace the Affordable Care Act was leaked Thursday after a meeting among Senate Republicans, The New York Times reports.
  • The document is a blueprint modeled after the House Republican’s plan called A Better Way, with age-based tax credits to help people buy insurance and more reliance on health savings accounts.
  • President Donald Trump said in a tweet early Friday that repeal and replace of the ACA is “moving fast” and House Speaker Paul Ryan said earlier this week he expects legislation to be introduced possibly as early as next week.

Dive Insight:

The GOP plan leaked Thursday contains few surprises but does leave out some key areas. It makes no mention of changing Medicare into a premium support plan, which Ryan has supported but Trump has been wary of.

The plan also makes no mention of how it would be paid for. Bloomberg has reported, however, that the GOP may be considering capping the tax break on employer-sponsored health insurance. This would be a major tax policy change. Policy analysts tend to support the idea but it could be a tough sell for lawmakers eyeing reelection.

The plan does address Medicaid, and essentially guts the expansion put forward by the ACA. It would roll back the generous cost sharing for states that expand eligibility and give states either a fixed sum per beneficiary or a block grant. Either way, far fewer people would be covered, leading to more uninsured and without access to care.

This could be unpopular, even among fellow Republicans. A handful of GOP governors in expansion states have said the move has improved healthcare access and their state’s economy.

Congress returns Tuesday and Republican leaders will push for legislation to be introduced as soon as they receive more guidance from the Congressional Budget Office, which is scoring some of their proposals.

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Filed Under: Health Law Policy & Regulation
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