Here are highlights of the legislation unveiled Monday by House Republicans as they move to dismantle former President Obama’s health care law and replace it with a system designed along conservative lines. Primarily affected would be some 20 million people who purchase their own private health plans directly from an insurer and the more than 70 million covered by Medicaid, the federal-state program for low-income people.
Here’s a look at some of the major components:
PRIVATE HEALTH INSURANCE
- Provides tax credits for people purchasing their own health insurance. The subsidies would be keyed primarily to age, rising as people get older. Financial assistance would be phased out for individuals making more than $75,000 and married couples earning more than $150,000. Subsidies could be used to buy any plan approved by a state.
- Eliminates cost-sharing subsidies in Obama’s Affordable Care Act that helped people with modest incomes meet the costs of insurance deductibles and copayments. States, however, would have the option of providing similar assistance with federal financing.
- Greatly expands contributions to health savings accounts, which allow people with high-deductible insurance to cover expenses that their plans don’t pay for.
- Protects people with pre-existing health problems from being denied coverage. However, consumers must maintain continuous coverage - otherwise, they would face a flat 30 percent surcharge on top of their premiums. States could use federal money to create high-risk pools as insurers of last resort.
- Preserves ACA provision that let young adults stay on parental coverage until they turn 26.
- Allows insurers to charge their oldest customers up to 5 times what they charge young adults. The ACA limits that to 3 times.
- Prohibits use of tax credits to purchase any plan that covers elective abortions. Currently if a health plan covers abortions it must collect a separate premium to pay for such procedures.
- Maintains the ACA’s higher federal financing for expanded Medicaid through the end of 2019. After that, states can only continue to receive enhanced federal payments for beneficiaries already covered by the expansion, which has mainly helped low-income adults with no children living at home. But for newly enrolled beneficiaries, the federal government would provide a lower level of financing.
- Overhauls the broader Medicaid program to end its open-ended federal financing. Instead, each state would receive a limited amount based on its enrollment and costs. That federal payment would be increased according to a government measure of medical inflation.
- Imposes a one-year funding freeze on Planned Parenthood, a major provider of women’s health services, including abortion.
PENALTIES & TAXES
- Repeals the ACA’s tax penalties on people who remain uninsured and on larger employers who do not offer coverage. The repeal is retroactive to 2016.
- Repeals the ACA’s taxes on upper-income earners, investors, health insurance plans and medical device manufacturers. Repeals 10 percent sales tax on indoor tanning.
- Expected to cover fewer people than the Obama-era law, but final estimates are not yet available from the Congressional Budget Office.
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