“It is important to note that this is just a draft and the bill may be revised before it is introduced.
Here’s a quick rundown of the key parts of the draft bill. It would:
- Penalize those who have a lapse in health coverage: A person who has let his or her health insurance lapse for a specified time will face a premium penalty up to 30% above the baseline when entering a plan. This is most likely designed to encourage people to sign up for care without a mandate.
- Shift tax subsidies to block grants based on age: Instead of tax subsidies based on income, as in the ACA, the House GOP plan would give every American a chunk of money to purchase insurance based on their age. The lowest amount would be for people under 30, who would receive $2,000 annually.
- Eliminate Medicaid expansion by 2020: Today the federal government provides states funding to expand Medicaid, the government program that provides insurance for low-income Americans. The bill would end that level of funding in 2020 and begin to provide lower amounts to states if they wish to continue covering people who have gained access to Medicaid under the ACA. Many Republican governors and senators do not want Medicaid expansion repealed.
- Provide funding to states to establish high-risk pools and increase coverage:The federal government would provide $15 billion in both 2018 and 2019 and $10 billion each year through 2026 for “State Innovation Grants” for things like “covering high-risk individuals,” “stabilizing premiums” in the individual insurance market, and “promoting access to preventative services.” This seems to be funding for high-risk pools, essentially a separate market for those with preexisting conditions to get access to coverage.
- Allow states to determine “essential health benefits”: The ACA has a list of benefits that must be covered by a plan on the exchanges to qualify for a metal level. The House bill would allow states to instead determine those essential benefits starting in 2020.
- Appear to prohibit federal funding to Planned Parenthood and abortion providers: Under the bill, no funding from the federal government to the states could be provided to any organization that “provides abortions” except in the cases of rape, incest, or the life of the mother. Planned Parenthood would appear to fall under this category. House Republicans have moved to defund the organization previously.
- Allow those on an individual insurance plan from before the ACA to continue their coverage: Previously, those in individual health plans before Obamacare would eventually have to switch from their old plans onto a new exchange plan. The replacement bill would allow insurers to continue to offer these grandfathered plans and for people to stay on them in perpetuity.
- Change the age band for cost of coverage: The ACA says premiums for elderly people can be no more than three times the cost of those for young people. The new plan would change that to five times.
- Repeals the tax on tanning bed businesses and other minor Obamacare taxes: Almost all of the tax provisions from the ACA, including a 10% tax on tanning-bed locations, would be repealed.”