- A draft bill for repealing the ACA that was leaked Friday would phase out Medicaid expansion by 2020, eliminate the individual mandate and replace income-based subsidies with age-based tax credits, Politico reported.
- It would be paid for with a cap on the tax exemption for employer-sponsored insurance at the 90th percentile of current premiums.
- The proposal also includes $100 million for state innovation grants that would help provide coverage for high-risk people and could be used in efforts to stabilize premiums.
The bill has not been formerly introduced and is subject to change, particularly after it is scored by the Congressional Budget Office, but it offers the best glimpse yet of what the GOP plans to put in place of the ACA.
Except for hard-line conservatives, Republicans in Congress have been growing more cautious with plans to “repeal and replace.” Many faced angry crowds at home this week as town hall forums were flooded with people protesting repeal. Recent polls have shown the ACA growing in popularity with voters, and one showed the highest amount of support ever for the law.
Analyses of previously leaked outlines of the repeal legislation have estimated that the average cost for exchange enrollees would go up by more than $1,700 a year. The GOP plan would also cover far fewer people. Since the ACA was implemented the rate of uninsured in the country has reached its lowest level ever, but that is now threatened.
Some of the provisions in the draft bill would be politically difficult, even within the Republican Party. Several GOP governors have said they would not support the provision to roll back federal Medicaid expansion funding from more than 90% to a much lower amount based on the number of enrollees.
And the funding mechanism, while touted by economists on both sides of the aisle, will anger the business community.
Also on Friday, President Donald Trump told the crowd at the Conservative Political Action Congress the ACA would be repealed and replaced, but did not give any details or a time line. He had previously said he expected to see a plan in March. He tweeted Friday morning that “we are going to save Americans from this crisis, and give them the access to the quality healthcare they deserve!”
As repeal and replace discussion continues on Capitol Hill, the CMS has given the ACA another blow by allowing plans that are not compliant with the law to continue until the end of 2018. The Trump administration has, however, taken some measurers to try to stabilize the exchange markets as major insurers announce their intentions to stop participation.