House Republican draft of Obamacare repeal bill, 2017

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A copy of a House Republican draft bill to repeal the Affordable Care Act (ACA), commonly known as Obamacare, was obtained by Politico on February 24, 2017. The bill is a reconciliation bill, meaning it impacts the budgetary and fiscal provisions of the ACA, and does not contain a provision to repeal the law in its entirety. However, the bill does repeal most of the law's taxes and fees, the penalty that enforces the individual mandate, and the financial assistance the law provides individuals to purchase health insurance.

HIGHLIGHTS
  • Rather than the tax credits and subsidies based on income included in the ACA, the bill would provide tax credits based on age.
  • In place of the individual mandate, the bill would require insurers to increase monthly premiums by 30 percent for one year for individuals who did not maintain continuous health insurance coverage.
  • The bill would leave it up to states to decide which benefits insurers must cover, rather than requiring a federal standard set of benefits.
  • Text of plan

    Summary

    On February 24, 2017, Politico obtained and released a draft document of a bill from House Republicans to repeal the Affordable Care Act (ACA), commonly known as Obamacare. The bill is a reconciliation bill, meaning it impacts the budgetary and fiscal provisions of the ACA, and does not contain a provision to repeal the law in its entirety.[1][2]

    However, the bill would repeal the penalties on individuals for not maintaining health coverage and on employers for not offering coverage. The law's advanced premium tax credits and cost-sharing subsidies that are provided to individuals to purchase insurance through the health insurance exchanges would end. Instead, the proposal would provide different tax credits based on age rather than income. Individuals under 30 would receive a $2,000 annual credit, which would increase by age up to $4,000 for individuals over the age of 60.[1][2]

    In place of the individual mandate, the bill would require insurers to increase monthly premiums by 30 percent for one year for individuals who did not maintain continuous health insurance coverage. While individuals could enroll during special enrollment periods, the bill would require proof of eligibility for special enrollment. Insurers would still be prohibited from denying coverage because of a pre-existing condition, but the bill would also provide $100 billion to states to establish various methods of covering particularly high-risk individuals with such conditions.[1][2]

    Insurers would no longer be required to offer a standard set of benefits determined by the federal government. Instead, the bill leaves it to states to decide which benefits insurers must cover. Insurers would also be allowed to charge older individuals premiums up to five times greater than younger individuals. Under the ACA, older individuals could only be charged premiums up to three times greater than younger ones.[1]

    The bill would end the ACA's Medicaid expansion, which allowed states to widen eligibility for the program to individuals earning incomes up to 138 percent of the federal poverty level. Instead, the proposal would provide states with fixed per-member funding, adjusted only for the health status of enrollees. States could still provide Medicaid coverage to their expanded eligibility level, but would not get enhanced federal funding for doing so as they did under the ACA.[2][3]

    The bill would repeal most of the ACA's taxes and fees, such as the taxes on pharmaceutical manufacturers, medical devices, health insurance plans, and tanning beds. The bill would, however, maintain a tax on premium contributions made by employers, similar to the 40 percent excise tax (called the Cadillac tax) included in the ACA. Under the draft bill, however, employer benefits above 90 percent of 2019 premium amounts would be taxed as regular income.[1][2]

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    See also

    Footnotes