Know this about GOP health bill

Questions remain but analysts agree: Expect changes in legislation.

By approving a major overhaul

this month of the 2010 health law known as Obamacare, House Republicans have raised ques

tions among voters on precisely what kind of coverage they will receive if the Senate approves the same version.

The non-partisan Congressional Budget Office has not analyzed the latest House GOP bill. But in March, the CBO analyzed a similar version and concluded it would increase the number of Americans without health insurance or government coverage by 24 million by 2026.

About 155 million Americans are insured by their employers, 55 million are covered by Medicare — which pays health costs for the elderly — and another 74 million by Medicaid, the joint federal and state program that provides health care for low-income people.

But until President Barack Obama signed the law in 2010, roughly 46 million Americans were not covered, many of whom worked for small companies which do not insure their workers. Those are the people most impacted by the House GOP bill.

Obamacare cut the number of people without coverage by 40 percent in two ways. Families of four earning between $34,000 and $98,400 a year can receive federal tax credits to buy individual insurance policies through the federal or state marketplaces, known as exchanges.

In addition, the law expanded Medicaid eligibility. The federal government provided billions of dollars to the states to cover a family of four earning as much as $33,948 a year, which is 138 percent above the federal poverty line. Gov. John Kasich accepted the federal dollars to provide health coverage to 700,000 people in Ohio.

Here is how the House Republican bill impacts you.

Q: Could a person without insurance still buy a plan in the exchanges?

A: Yes. The Republican plan keeps the exchanges but it bases the refundable tax credit on a person’s age as opposed to their income as Obamacare does. For example, a person up to age 29 would receive a $2,000 credit while someone age 60 and older would be eligible for a $4,000 credit. A person between the ages of 50 and 59 would be eligible for a $3,500 tax credit, a change from the original House bill.

Q: Does the House GOP bill provide fewer benefits for private plans?

A: Depends where you live. Obamacare requires that policies sold through the marketplaces include 10 essential benefits, such as hospitalization, maternity and newborn care, prescription drugs, and laboratory services. The House Republicans did not change that in the bill, but made it possible for states to do so. Beginning in 2020, states can ask the federal government for permission to allow insurance companies to offer plans with fewer benefits.

A: They argue giving consumers greater choices would increase competition. They say it would lower premiums by allowing insurance companies to cover fewer benefits. They contend healthy people would more likely buy policies that don’t cost as much even if they offer fewer guaranteed benefits.

Q: Does the Republican plan offer the same guarantee as Obamacare that people with pre-existing conditions, such as high blood pressure, cancer, or heart trouble, can buy health insurance?

A: Yes, but there is a catch. Under the Republican plan, states can ask to opt out of community ratings, which requires insurance companies in a particular geographic area to charge the same premiums for all people, no matter their health condition. That means if someone lives in a state that receives a waiver and they have a lapse in coverage for more than 63 days, they could be charged higher premiums for one year to buy individual policies on the exchanges. States receiving a waiver would have to establish high risk pools for people subject to higher premiums or a re-insurance program that would hopefully lower premiums. The House bill includes $138 billion during the next nine years to establish these programs.

Q: Can your kids still remain on your policy up to age 26?

A: Yes.

Q: Are abortion services covered?

A: No. Under the GOP plan, the tax credits cannot be used to buy a plan that offers abortion services, except for procedures to protect the life of the woman, or in cases of rape or incest.

Q: Does Medicaid coverage change?

A: Yes. Starting in 2020, the federal government would cap federal Medicaid dollars available to the states and eliminate the federal dollars Kasich has used to expand Medicaid. People who were in the expanded program before 2020 would be grandfathered in, but those dropping out would not be allowed to return, meaning the number of those people on expanded Medicaid coverage would shrink. States could continue to provide expanded Medicaid coverage, but would have to pick up more of the costs. The bill prohibits Medicaid dollars from being paid to Planned Parenthood clinics.

Q: Is it true House Republicans cut taxes for the wealthy?

A: For the most part, yes. Congress approved a number of taxes in 2010 to finance Obamacare. As of next January, the House bill repeals investment taxes on married couples earning more than $250,000 a year, a Medicare surcharge on wealthier people, a 2.3 percent tax on the sale by companies of medical devices, and higher taxes on pharmaceutical companies. The bill scraps penalties on individuals who failed to buy an insurance policy and repeals what has become known as the Cadillac tax, which is a tax on expensive insurance plans offered by some employers. Overall, the bill would cut taxes by $765 billion during the next 10 years.