Health act re­place­ment in GOP draft

It would dump fines, Med­i­caid ex­pan­sion, cre­ate tax cred­its

Northwest Arkansas Democrat-Gazette - - NATIONAL - ALAN FRAM In­for­ma­tion for this ar­ti­cle was con­trib­uted by Ricardo Alonso-Zal­divar of The As­so­ci­ated Press.

WASH­ING­TON — A draft Repub­li­can bill re­plac­ing the Pa­tient Pro­tec­tion and Af­ford­able Care Act would end its Med­i­caid ex­pan­sion, scrap fines on peo­ple not buy­ing in­sur­ance and elim­i­nate taxes on the med­i­cal in­dus­try and higher earners.

In­stead, it would cre­ate tax cred­its worth up to $4,000, al­low big­ger con­tri­bu­tions to per­sonal health sav­ings ac­counts and im­pose a new levy on health cov­er­age some em­ploy­ees get at work.

The 105- page mea­sure largely tracks talk­ing points that House Speaker Paul Ryan, R-Wis., un­veiled last sum­mer and a sim­i­lar out­line that GOP lead­ers re­cently gave law­mak­ers. The doc­u­ment is 2 weeks old, and GOP aides said it is sub­ject to change.

Still, it pro­vides some new de­tails of Repub­li­can think­ing and reaf­firms oth­ers, such as block­ing fed­eral pay­ments to Planned Par­ent­hood for a year.

It also shows Repub­li­cans have be­gun trans­lat­ing their ideas into leg­isla­tive lan­guage, even as they con­tinue their seven-year strug­gle to unify their party be­hind a bill re­peal­ing for­mer Pres­i­dent Barack Obama’s 2010 over­haul.

Though just a pre­lim­i­nary doc­u­ment, the pack­age drew quick crit­i­cism from Democrats.

“This isn’t a re­place­ment, it’s a recipe for dis­as­ter,” said Se­nate Mi­nor­ity Leader Charles Schumer, D-N.Y. He said it would “put in­sur­ance com­pa­nies back in charge” while boost­ing health care costs for mil­lions and kick­ing mil­lions of oth­ers off their plans.

“The Repub­li­can bill raises fam­i­lies’ costs, weak­ens cov­er­age and pushes mil­lions of Amer­i­cans off of health cov­er­age of any kind,” said House Mi­nor­ity Leader Nancy Pelosi, D-Calif.

Con­gres­sional lead­ers say they want com­mit­tees to write leg­is­la­tion re­shap­ing the na­tion’s health care sys­tem in March. That rep­re­sents slip­page from ear­lier sug­ges­tions by Pres­i­dent Don­ald Trump and GOP lead­ers of quicker ac­tion.

It is un­cer­tain how their plans will be af­fected by this week’s town halls dur­ing Congress’ re­cess where GOP law­mak­ers were con­fronted by noisy de­fend­ers of Obama’s law.

Ac­cord­ing to the Repub­li­can draft, in­sur­ers could charge older cus­tomers five times more than what they charge younger ones, who are gen­er­ally health­ier and less costly to cover. That ra­tio is lim­ited to 3-1 un­der Obama’s statute.

The GOP plan would end an ex­pan­sion of Med­i­caid to peo­ple just over the poverty line that has been adopted by 31 states — many with Repub­li­can gov­er­nors — and has led to cov­er­age of 11 mil­lion ad­di­tional low-in­come peo­ple.

Over­all, Med­i­caid serves more than 70 mil­lion peo­ple who au­to­mat­i­cally re­ceive cov­er­age for much of their med­i­cal care. Un­der the GOP bill, Med­i­caid spend­ing would be curbed by pro­vid­ing states fixed an­nual amounts per ben­e­fi­ciary.

The tax penalty on peo­ple who don’t pur­chase poli­cies would be elim­i­nated, as would fed­eral sub­si­dies for lower earners who buy in­sur­ance.

In­stead, those who don’t get cov­er­age at work or un­der gov­ern­ment pro­grams would get an­nual tax cred­its based on age, grow­ing from $2,000 for peo­ple un­der age 30 to $4,000 for those age 60 and over. Repub­li­cans would also make it eas­ier for peo­ple to con­trib­ute more money to health sav­ings ac­counts.

Un­der Obama’s over­haul, peo­ple with lower in­comes cur­rently get larger sub­si­dies. Democrats say the GOP pro­pos­als would leave peo­ple short of what’s needed to af­ford med­i­cal bills and that most are al­ready too strapped to save money.

The GOP pro­posal would also:

Let in­sur­ers charge 30 per­cent higher pre­mi­ums for peo­ple who have let their cov­er­age lapse.

Re­peal taxes Obama’s law im­posed to pay for its cov­er­age ex­pan­sions in­clud­ing on health in­sur­ers and phar­ma­ceu­ti­cal com­pa­nies, in­vest­ment in­come of higher earners and on many med­i­cal de­vices.

Tax health cov­er­age work­ers re­ceive from em­ploy­ers ex­ceed­ing a cer­tain value.

Scrap Obama’s re­quire­ment that in­sur­ers cover 10 kinds of ser­vices like pre­scrip­tion drugs and ma­ter­nity care, in­stead let­ting states de­cide.

End the tax penalty on larger em­ploy­ers who don’t of­fer health cov­er­age to work­ers.

Pro­vide $100 bil­lion over 10 years for grants to states to re­strain health costs.

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