GOP releases bills to repeal and replace ObamaCare

[randomname]

House Republicans on Monday unveiled their long-awaited legislation to repeal and replace ObamaCare.

The two measures dismantle the core aspects of ObamaCare, including its subsidies to help people buy coverage, its expansion of Medicaid, its taxes and its mandates for people to have insurance. (READ THE BILLS HERE AND HERE.)

In its place, Republicans would put in place a new system centered on a tax credit to help people buy insurance.

That tax credit would range from $2,000 to $4,000 a year, increasing with someone’s age. That system would provide less financial assistance for low-income and older people than ObamaCare, but could give more assistance to younger people and those with somewhat higher incomes.

Democrats warn that between the phasing out of ObamaCare’s Medicaid expansion and the smaller tax credit for low income people, coverage would be put at risk for many of the 20 million people who gained it from ObamaCare.

Republicans acknowledge that their plan will cover fewer people, saying unlike ObamaCare, they are not forcing people to buy coverage through a mandate. They say their system is less intrusive and provides people a tax credit without mandates or a range of tax increases.

House committees are expected to vote on the measures this week, with the full House voting on it soon after that.

House Ways and Means Chairman Kevin Brady (R-Texas) said Monday on Fox News he's confident the bill will pass with full Republican support despite recent party infighting over the details.

"We've been listening very carefully to our Republican members for months now to make sure we get it right," he said. "I am confident we are going to pass this." He noted that many of the elements of the bill have passed the House "a number of times" over the years.

The measure faces a rocky path, particularly in the Senate. Four Republican senators earlier Monday objected to an earlier version of the House bill, saying that it failed to protect ObamaCare’s Medicaid expansion.

But under the bill, the repeal of the Medicaid expansion would not take effect until 2020, and Republicans would grandfather in current enrollees so that they can stay on the program. But once 2020 arrives, the federal government will no longer provide the extra federal funds that allow for expansion.

That plan has drawn objections from more centrist Republican senators, who want to protect the expansion and are worried about constituents losing coverage and their states losing federal funds.

Even in the House, there are objections to the plan. Conservatives in the House Freedom Caucus call the bill's tax credit is a “new entitlement.” They have enough votes to kill the bill, but it remains to be seen whether they will actually vote against it.

The bill would maintain ObamaCare’s protections for people with pre-existing conditions, who could still not be denied coverage. Instead of ObamaCare’s mandate, the bill would seek to incentivize healthy people to sign up by allowing insurers to charge people 30 percent higher premiums if they have a gap in coverage.

The measure also repeals ObamaCare’s taxes, such as the medical device tax and health insurance tax, starting in 2018.

The bill scraps a controversial Republican proposal in earlier drafts to start taxing some employer-sponsored health insurance. Instead, the measure would keep ObamaCare’s "Cadillac tax" on generous healthcare plans starting in 2025, in order to prevent that legislation from adding to the deficit in that decade.

 

[randomname]

FULL TEXT: http://energycommerce.house.gov/sit...gov/files/documents/AmericanHealthCareAct.pdf

 

[randomname]

 

[MallsRGood]

Obamacare Lite

Even in the House, there are objections to the plan. Conservatives in the House Freedom Caucus call the bill's tax credit is a “new entitlement.” They have enough votes to kill the bill, but it remains to be seen whether they will actually vote against it.

Courage fellas

 

[devil21]

Quick perusal looks like the fine/tax paid to the IRS/govt was removed and was replaced with a "penalty" paid to the insurance company if coverage lapses. So either way there's essentially a mandate to maintain coverage or pay up. Sounds legit.

 

[inthehall]

 

[Zippyjuan]

The bill would maintain ObamaCare’s protections for people with pre-existing conditions, who could still not be denied coverage. Instead of ObamaCare’s mandate, the bill would seek to incentivize healthy people to sign up by allowing insurers to charge people 30 percent higher premiums if they have a gap in coverage.

Kinda takes away the incentive to get insurance if you don't already have it. If you can't get more healthy people to sign up and spread around the people paying in, costs will be higher and rates will continue to rise.

The two measures dismantle the core aspects of ObamaCare, including its subsidies to help people buy coverage, its expansion of Medicaid, its taxes and its mandates for people to have insurance. (READ THE BILLS HERE AND HERE.)

In its place, Republicans would put in place a new system centered on a tax credit to help people buy insurance.

That tax credit would range from $2,000 to $4,000 a year, increasing with someone’s age. That system would provide less financial assistance for low-income and older people than ObamaCare, but could give more assistance to younger people and those with somewhat higher incomes.

Tax credits are still subsidies.

 

[NorthCarolinaLiberty]

Kinda takes away the incentive to get insurance if you don't already have it.

That actually looks like a poorly worded sentence from the author. I'd rather just read the text of the proposal, or at least key parts.

Anyway, it's sounds like you are against this replacement. Does that mean you are/were for Obamacare?

Instead of just picking apart something all the time, please state your views as most everyone else does on this forum. Thanks!

 

[CPUd]

https://twitter.com/scottwongDC/status/838902946628780033

 

[NorthCarolinaLiberty]

Why replace it? Could have been simple, as in Repeal and replace Obamacare.

 

[CPUd]

https://twitter.com/justinamash/status/838889979501760514

 

[qh4dotcom]

Tax credits are still subsidies.

Why?

 

[pao]

My understanding is that some people will get back more money (tax credit) than they put in (taxes).

 

[MallsRGood]

My understanding is that some people will get back more money (tax credit) than they put in (taxes).

Definitely

The whole point seems to be to maintain Obamacare coverage, just using a different, more conservative-sounding, funding mechanism.

I'd expect most of the people currently getting subsidies to end up with "tax credits" in a similar amount.

 

[spudea]

where's the repeal?

 

[UWDude]

Quick perusal looks like the fine/tax paid to the IRS/govt was removed and was replaced with a "penalty" paid to the insurance company if coverage lapses. So either way there's essentially a mandate to maintain coverage or pay up. Sounds legit.

Except you dont have to buy health insurance. So its not forced at gunpoint.

 

[CPUd]

The GOP’s Obamacare Repeal Bill Is Here. Is This Just Obamacare Lite?

The House bill trades one set of tax credits for another.

Peter Suderman|Mar. 6, 2017 8:30 pm

After months of confusion and secrecy, House Republicans have finally revealed their Obamacare repeal legislation. While it's useful to have House Republicans on the record with a legislative plan, the plan doesn't offer any estimate for how much it would cost, or how many people it would (or wouldn't) cover. In general, it's not clear what problems this particular bill would actually solve.

The bill would replace Obamacare's subsidies with a system of tax credits and halt the law's Medicaid expansion at the end of the decade while grandfathering in many beneficiaries over the long term and giving states $100 billion in funding to work with to care for hard case patients. All in all, it's a fairly conventional Republican plan, modified in ways designed to mitigate recent political objections.

The tax credit is, for the moment, the most controversial component of the legislation. As in previous drafts of the bill, the credits are refundable, meaning that individuals will be eligible for them even if their total tax liability is lower than the amount of the credit. The federal government would pay people, even if their federal tax bill was zero. It's a subsidy, basically, rather like the one in Obamacare. Conservative legislators have argued that such a system would be little more than Obamacare lite. Sen. Rand Paul (R-Kentucky) has complained that any refundable credit is tantamount to "a new entitlement program."

Unlike Obamacare, which bases its credits on income, the GOP bills we've seen so far are based on age. That creates another set of political headaches, because it means that wealthier folks get tax credits, and because it means that older people would get less help than under Obamacare, in hopes of creating a scheme that lures more young and health people into the system.

The bill released tonight attempts to mitigate these problems by capping the refundable credit so that households earning more than $150,000 would be reduced, and individuals making more than $215,000 would get nothing at all. But that still leaves a credit that is refundable for most people, and adds a bit of additional administrative work: Under Obamacare, judging an individual's employment and income has proven more than a little difficult, and the same would continue to be true here.

So Republicans would be replacing one set of insurance subsidies with another set of insurance subsidies, while killing the individual mandate but leaving many of the law's insurance regulations intact (with a penalty for insurance gaps). There's a reason that legislators like Michigan Rep. Justin Amash are already referring to it as "Obamacare 2.0."

On the other hand, the bill would probably result in the disruption of current health insurance for millions (although it's hard to say with confidence how many, for reasons I'll explain in a moment), and we don't yet have an estimate as to what effect it would have on the budget.

Beyond that, the bill would provide a hefty payment to states, about $100 billion over 10 years, for states to use to fund safety nets of their own design. And then there's the bill's Medicaid rollback, another awkward balancing act. It keeps the state-level optionality granted by the Supreme Court in 2012, and allows states to keep the law's expanded funding for Medicaid beneficiaries up through the end of 2019, and for those who maintain continuous coverage after. So the enhanced Medicaid matching funds provided by Obamacare would dwindle away over time. This is as much a political compromise as an actual policy measure. Will it appease the four Republican Senators who pledged today to oppose the repeal of the law's Medicaid expansion? No one knows.

Indeed, there's an awful lot we still don't know about the bill, in part because Republicans have rolled it out in such a way as to prevent clear analysis.

With any major health care policy reform, the big questions are: How much will it cost? And how many people will it cover, and in what manner? Typically these questions are answered by the Congressional Budget Office (CBO), which provides the official estimates, and perhaps supplemented by outside organizations with various rooting interests.

But there's no CBO score of the Republican bill. And reports indicate that Republicans intend to proceed moving the bill through the committee process without any CBO score to guide them. That means that neither the public nor congressional legislators will have any real idea of what the likely effects of the bill are even as they are debating its merits.

Of course the CBO has been wrong before—in particular about health care. And of course there are reasonable issues CBO process, which is built to produce authoritative single point estimates rather than ranges that might better express the level of uncertainty in the estimates.

But the CBO does serve one incredibly valuable function, which is to provide an official estimate for the budgetary effects of a law, and (more or less) force everyone to stick with it, or at least make a clear argument as to why they aren't.

We don't have that here, and the result is that even though the bill is now public after a period of unusual secrecy—members of the House were allowed to read it only in a tightly controlled setting last week, while Senators were prohibited from looking at it—there's a lot we still don't know about how it is likely to work.

More broadly, it's not clear what constituency this bill is designed to satisfy, aside from Republican congressional leadership. It doesn't go far enough for conservatives, but may not be generous enough to appease more moderate Republicans either. (Democrats are, at this point, virtually certain to uniformly oppose the bill.) It's a muddled version of the House GOP plan, which was itself a muddled vision of what a political compromise might look like, in some hypothetical world where Republicans actually agreed about health policy.

The GOP's real problem, in terms of passing legislation, isn't that the party can't agree on specifics, or that legislators need to bargain their way toward a compromise that gives everyone something they want. It's that they don't agree on, or in some cases even have, basic goals when it comes to health policy. This bill, and the aura of secrecy surrounding it, seems more like a wish and a hope that this essential problem goes away rather than an attempt to truly solve it.

So what we have at this point is a bill, but not a lot of context. It's a start, and it's better than nothing. But it's not enough.

https://reason.com/blog/2017/03/06/the-gops-obamacare-repeal-bill-is-here-i

 

[Keith and stuff]

Kinda takes away the incentive to get insurance if you don't already have it. If you can't get more healthy people to sign up and spread around the people paying in, costs will be higher and rates will continue to rise.

I agree with you on this and everyone else here. Either allowing extra charges for people with pre-existing conditions or allowing insurers to charge people 30 percent higher premiums if they have a gap in coverage is a must, at a minimum. This is a great start, but obviously could be much more free market.

 

[Keith and stuff]

Except you dont have to buy health insurance. So its not forced at gunpoint.

Exactly. There is no comparing at all. The same thing happens with auto insurance, as it should if insurance companies want it. The government isn't enforcing companies to do this. Ideally, obviously, companies should be able to charge as much as the market will bear for this. That's why I support this, as a min. It isn't pro-liberty enough, but it is certainly something we can all agree on, as a min.

 

[TheCount]

Why?

Regardless of the method, this essentially means both parties are agreeing that health care is something that the government owes the people. Oh, and it's a net pay for some people. And by some people, I mean the very large percentage of people who pay little to no net federal taxes.