House Republicans this month unveiled legislation in line with President Trump’s campaign pledge to repeal and replace the 2010 Affordable Care Act (ACA), more commonly known as Obamacare.
In an effort to overhaul ACA, which Republicans have called a disaster due to bailing insurers and rising premiums, the GOP’s newly debuted American Health Care Act repeals central tenants of ACA including its expansion of Medicaid.
White House Press Secretary Sean Spicer touted the difference in size among the two pieces of legislation in a March 7 press briefing following the reveal of the GOP’s health care replacement.
“Look at the size — this is the Democrats, this is us,” Spicer said, pointing at printed versions of the ACA and the much smaller Republican health care bill. “You can’t get any clearer that this is government, this is not.”
The GOP legislation is 123 pages long, while the ACA was more than 900 pages.
Though it took former President Barack Obama and other ACA backers more than a year to pass the legislation, Republicans are hoping to avoid lengthy debate. House Speaker Paul D. Ryan said he hopes to schedule the full House vote for the week of March 20 so it can be sent to the Senate and, eventually, President Trump.
The bill has already passed through two key committees.
The proposed Republican bill will keep several components of Obamacare, including dependent coverage until age 26, policies that require insurers to cover people regardless of preexisting medical conditions, and a requirement for the 10 essential health benefits insurers to offer coverage for maternity care and preventative services. It will also keep prohibitions on annual and lifetime insurer coverage limits.
The Republican legislation will however, repeal vital parts of Obamacare, including its individual mandate which required people to obtain health care to avoid tax penalties, a part of the law meant to keep insurance affordable for the sick and elderly. The GOP plan proposes a “continuous coverage incentive,” which would charge people in the individual market a 30 percent penalty for lapses in health insurance coverage.
The employer mandate requiring larger companies to affordable insurance to employees and subsidies and federal tax credits for out-of-pocket expenses will also be eliminated.
The new bill will change the way premium subsidies are distributed by using age instead of income. Under the new proposed plan, more substantial amounts can be put into health savings accounts and insurers will be able to charge older customers five times as much as younger ones compared to three times under ACA.
Under ACA, more than 30 states expanded Medicaid coverage by raising the eligibility cutoff to 138 percent of the poverty level. Federal funding of the expansion will only be supported until 2020 with the new bill.
Democrats are accusing Republicans of rushing the bill before the public can voice their opinions on it. Republicans dispute the charge, saying the plan resembles one that House Republicans worked on last year and championed under Ryan.
The bill saw 26 straight hours of markup directly following its reveal.
“No one believed the Republicans had a bill … until Monday night,” Maryland Rep. Steny Hoyer said on the House floor Friday.
“No matter how you dress it up, Mr. Speaker, that is not regular order,” said Hoyer, who has since launched a website for Americans to voice their thoughts on the GOP replacement bill. “What it is trying to jam through a bill before the American public has an opportunity to tell us what they think about the bill.”