- Intent on repealing the Affordable Care Act as quickly as possible, House Republicans have been working with the Congressional Budget Office on aspects of a replacement bill, The Hill reported.
- Areas being discussed with the bipartisan budget office include tax credits, funding for high-risk pools and Medicaid changes.
- GOP leaders plan to fast-track repeal using the budget reconciliation process, which prevents a filibuster by Senate Democrats.
Specific aspects under review include tax credits to help low-income individuals buy insurance, high-risk pool funding to help payers cover sicker customers and changes to Medicaid funding.
That issue could be particularly tricky to hammer out. States that expanded Medicaid under the ACA want to keep the added federal payments they received during that time, while those that didn’t don’t want to be slighted for not expanding eligibility.
Republicans have also talked about capping federal funding to states under Medicaid.
The GOP’s effort to work with CBO is interesting because the budget office recently said it won’t count minimal products as coverage. In a December blog post, the budget office said minimal insurance products that would “not provide enough financial protection against high medical costs to meet the broad definition of coverage” would not meet CBO’s definition of “coverage.” It's also interesting to note congressional Republicans have in the past questioned CBO's methodologies over ACA repeal.
House speaker Paul Ryan (R-WI) has said he wants to repeal the ACA by the end of March, leaving lawmakers little time to work out details of a replacement bill.
With insurance coverage for 20 million Americans at stake, coverage versus access will be flashpoint to watch under any replacement plan as the GOP need to message a “win” in healthcare reform. Working with the CBO seems to indicate they are trying to get this right and score well in the eyes of the public.