House Republicans Release Plan To Repeal and Replace Obamacare: Key Highlights

Tyler Durden's picture

Update: A seemingly angry (judging by the tone) Senate minority leader Chuck Schumer obviously had to lash out and dismiss the Republican's plan for "TrumpCare"...

"Trumpcare doesn't replace the Affordable Care Act, it forces millions of Americans to pay more for less care. This plan would cut and cap Medicaid, defund Planned Parenthood, and force Americans, particularly older Americans, to pay more out of pocket for their medical care all so insurance companies can pad their bottom line.

 

It cuts taxes on the rich to make middle class families pay more. To make matters worse, this sham of a replacement would rip treatment away from hundreds of thousands of Americans dealing with opioid addiction, breaking the President's word that he would expand treatment, not cut it.

 

This bill is a giveaway to the wealthy and insurance companies at the expense of American families, and Senate Democrats will work hard to see that it is defeated."

Wow, sounds like a nightmare. Let's see what the bill actually says.

As we detailed earlier, on Monday afternoon, House Republicans in both the Ways and Means and Energy and Commerce committees, unveiled their long-awaited legislation as part of House Republicans effort to repeal and replace Obamacare through the reconciliation process. The measure would roll back the government's health care role and is expected to result in fewer people having insurance coverage; however, due to strong opposition among key republicans to the proposed plan, there is a high likelihood the bills will not pass in their current form.

Upon releasing the legislation, House Energy and Commerce Committee Chairman Greg Walden said: “After years of Obamacare’s broken promises, House Republicans today took an important step. We’ve spent the last eight years listening to folks across this country, and today we’re proud to put forth a plan that reflects eight years’ worth of those conversations with families, patients, and doctors. Simply put, we have a Better Way to deliver solutions that put patients – not bureaucrats – first, and we are moving forward united in our efforts to rescue the American people from the mess Obamacare has created.

“With today’s legislation, we return power back to the states - strengthening Medicaid and prioritizing our nation’s most vulnerable. We provide the American people with what they’ve asked for: greater choice, lower cost, and flexibility to choose the plan that best suits their needs. Today is just the first step in helping families across this country obtain truly affordable health care, and we’re eager to get this rescue mission started.”

The plan would dismantle the key aspects of ObamaCare, including subsidies to help people buy coverage, the law's fines on people who don't purchase health insurance, the expansion of Medicaid, and drop the plan to tax employer-sponsored plans. The bills can be found here and here.

A breakdown of core aspects removed from the existing law (courtesy of Axios):

  • All Obamacare taxes
  • All Obamacare subsidies, including its premium tax credit
  • Individual, employer mandate penalties
  • "Cadillac tax"
  • No longer will limit the tax break for employer-sponsored health coverage
  • No payments to insurers for cost-sharing reductions
  • Selling insurance across state lines (can't be done in the "reconciliation" bill)
  • Medical malpractice reform (can't be done in the "reconciliation" bill)

What is being added:

  • Pre-existing condition coverage
  • Continuous coverage — 30 percent penalty if people don't keep themselves insured
  • Special fund to help states set up "high-risk" pools, fix their insurance markets, or help low-income patients
  • Enrollment in expanded Medicaid will be frozen
  • Current enrollees can stay until 2020, and keep getting extra federal funds, until they leave the program on their own
  • Medicaid will change to "per capita caps" (funding limits for each person) in fiscal year 2020
  • A new, refundable tax credit will be available in 2020 to help people buy health insurance
  • Covers five age groups — starts at $2,000 for people in their 20s, increases to $4,000 for people in their 60s
  • It's not means tested, but phased out for upper-income people (starting at $75,000 for individuals, $150,000 for families)
  • Insurers can charge older customers five times as much as young adults

At its core, in place of the existing Affordable Care Act legislation, republicans will implement a system centered on a tax credit to help people buy insurance.  That tax credit would range from $2,000 to $4,000 annually  increasing with 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 have warned 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. As The Hill adds, Republicans acknowledge that their plan will cover fewer people, but note that 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.

While some republicans such as House Ways and Means Chairman Kevin Brady are confident the bill will pass with full Republican support despite recent party infighting over the details, the measure faces a rocky path, particularly in the Senate.

Earlier on Monday, four Republican senators - Sens. Rob Portman, Shelley Moore Capito, Cory Gardner and Lisa Murkowski - objected to an earlier version of the House bill, saying that it failed to protect ObamaCare’s Medicaid expansion, saying they won't support a bill that takes the same approach to the program as a leaked Obamacare repeal and replacement bill did. However, under the proposed 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. Once 2020 arrives, the federal government will no longer provide the extra federal funds that allow for expansion.

As this is unlikely to solve the senators' problems with the bill, the proposed plan may be dead on arrival.

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

House Republicans have also objected to the plan, with Conservatives in the House Freedom Caucus calling 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.

As previously leaked, 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.

Finally, The Hill also notes that 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.

House committees planned votes on the legislation Wednesday at 10:30am. That will launch perhaps the year's defining battle in Congress, and GOP success is by no means assured because of internal divisions.

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SallySnyd's picture

 

As shown in this article, there is one significant issue that health care legislation seems unable to fix:

 

http://viableopposition.blogspot.ca/2017/01/buying-influence-americas-health-care.html

 

Big money and Big Pharma have impacted the American healthcare system, causing significant financial stress for American healthcare consumers.

Son of Loki's picture

My quantum mechanics professor told me I'm dopey enough already!

Adullam's picture

@xythras - Have you EVER posted a comment without a link to your site?

Spammer.

Escrava Isaura's picture

Say 10/20 years ago you were invited to the board meeting of the 500 largest US corporations, because these corporations were looking for an intelligent CEO to guide them into the future. If you had mention Trump as your choice the board of directors would have, at best, laugh at you. And, at worse, ridicule you then, have you removed.

Even that I do want Trump to succeed, because the alternative will lead us into a dark period that words cannot begin to contemplate, I am coming to the sad realization that the vast majority of Americans are going to look back in 2016 and realized what a funken mistake.

 

nmewn's picture

The last eight were the mistake Escrava and by the way, you might want to think about moving away from the DC area ;-)

FrozenGoodz's picture

I thought this was repeal and REPLACE .... Entitlement reform will never pass

Mikeyy's picture

Haha - repeal ?  That was NEVER going to happen.  It was just a scam to excite the Republican base.  

And this will increase the deficit.  So, more expensive, worse coverage, bigger deficit. 

The trifecta.  

 

 

johngaltfla's picture

If it doesn't pass, 5% down day for the DJIA. Watch and see.

Pairadimes's picture

The only long-term solution is to get the federal government entirely out of the healthcare business. People will always consume more of what someone else is willing to pay for.

Bigly's picture

The only long term solution is soylent green ;)

FireBrander's picture

Reverse the Medicaid expansion and KISS YOUR Republican Governorship GOOD-BYE!

FireBrander's picture

Not one FUCKING WORD IN THIS that aims at the REAL PROBLEM! COST!

Q: It's so fucking expensive, people cant' afford it! What should we do?

A: Print the money from thin air and "help" them pay for it.

 

LOWER THE FUCKING COST OF CARE/MEDS! GEESH!

 

Is this the Democrats or Republicans plan; yeah, one and the same.

TheAntiProgressive's picture

On meds / Pharma.  No pricing less internationally than what is charged here in the old USA.  Our taxes funded development and Big Pharma looks to the government to provide excess cash flow as they then wholesale for marketshare in overseas markets.  In the USA it is priced at "what the market will bear" and here in the USA it is the government and politicos lobbied by big pharma making damn sure the bearing point and pricing in this country is through the roof.

jeff montanye's picture

excellent point.  the rest of the world pays half as much as we do and gets better results: http://www.visualcapitalist.com/u-s-healthcare-system-global-outlier-not...

imo the best way is medicare and associated insurance ppo's for everyone (like medicare now) with negotiated lower prices on drugs and healthcare using medicares's market clout like the insurance companies do.

the_narrator's picture

The democrats only want to focus on who is paying and how much.  The point is is it doesn't matter because the price is astronomical and any solution is going to involve spending less money somehow.

Richard Chesler's picture

"pay more out of pocket for their medical care all so insurance companies can pad their bottom line."

Chuck sure knows how to describe OBOZOcare.

Rabbi Chaim Cohen's picture

Well let's see BEFORE Obamacare the "evil" health insurance companies were swimming in a lavish 6-7% profit margin. Today it's even less.

Before Obamacare healthcare facilities were required by law to eat the cost to care for anyone who showed up at their door sick but with no insurance. So the cries of uninsured were false. Of course no one was going to get their elective gender reassignement surgeries and prescriptions paid for by the US Taxpayer, but they shouldn't!

Once upon a time we needed tweaks and deregulation, sadly we received a permanent takeover. The problem was, is and will always be big government with their fingers in the pie.

tip e. canoe's picture

deflating the "healthcare space" will pop the GDP balloon and that's a no-no.

SubjectivObject's picture

Watch for exempting of big sickcare players from monopoly prosecution.

Consistent with Denninger's thesis, action on currently legal monopoly prosecution lilely can bring the entire complex down to earth.

But that door can be closed.  By example, this language is buried in Rand Paul's proposed legislation.

OldTrooper's picture

Agreed.  Chance of it happening...0.00%

wildbad's picture

as long as "pre-existing conditions" are covered, there is ZERO incentive for a young healthy person to engage with the system.

that 30% premium might actually do something to mitigate that fact.

JonNadler's picture

No, If it doesn't pass, 5% UP day for the DJIA. Watch and see.

justin423's picture

What were they thinking having all the punitive effects hit right before a Presidential election and the year several vulnerable Republican Senators are up for re-election?

Gardner and Heller voting for this would be political suicide along with a few others.

prime american's picture
prime american (not verified) justin423 Mar 7, 2017 6:17 AM

I'm making over $7k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life. This is what I do... http://bit.ly/2jdTzrM

Logan 5's picture
Logan 5 (not verified) nmewn Mar 6, 2017 8:19 PM

"The last eight were the mistake Escrava and by the way, you might want to think about moving away from the DC area ;-)"

 

I heard Mars is nice this time of year

nmewn's picture

Ain't it funny how Marxist/Socialists always want to talk about the kumbaya aspect of it all? Everyone pulling their own weight "for the greater good of society" while they're sitting at the top with their straws sucking the life blood out of everything.

Washington DC and its environs is pretty damned prosperous, us, not so much.

Fuck em.

Logan 5's picture
Logan 5 (not verified) nmewn Mar 6, 2017 8:57 PM

"with their straws sucking the life blood out of everything."

 

They're doin' it [to], oops, I mean [for] the kids.

turnoffthewater's picture

Lets see how the "let's pass this bill so we can see what's in it" bitch votes. Sorry, I meant corrupt cunt.

Clever Name's picture

One thing we can all agree on. I'll guarantee that whatever the 'fix' is for ADA, it will only be good for the insurance companies.

malek's picture

You're falling short in understanding again.

Ten years ago already the majority of the top 500 corporations would never look for the most "intelligent" CEO, but for the best psychopath to fill that role.
Because that will be the most successful person, in a society where everything is rigged.

Whoa Dammit's picture

It looks like they have accomplished the impossible and come up with a worse plan than OCare which benefits the fucking insurance companies even more than Ocare did.

The 30% penalty that insurance companies can charge if you let your insurance lapse is a killer. If you are laid off from your job or pissed off & quit but can't afford expensive Cobra payments, then you may never get another job, as a company that hires you would have to pay 30% more for your insurance. This is SlaveCare becuase you will be one if this bill passes. Fuck the RINOs.

BrownCoat's picture

I like the removal of forced insurance and the taxes! Cutting funding for welfare recipients and drug addicts is gravy!

FireBrander's picture

Went to the Christmas party at the wifes work...CEO stood up to speak...yeah, psychopath nailes it...I was standing at the back...30 seconds into his speech, I walked away to get another drink; whatever.

Luc X. Ifer's picture

'Funken mistake' - so, you regret missing the chance to smell fresh nuclear fallout in the morning?!

GhostofBastiat's picture

Say 10 years ago you were invited to the IOC city selection committee and asked to bet which country that you chose would completely and totally squander and waste all the spending associated with olympic games hosting. If you proposed Brazil, all in attendance would agree and congratulate you on your insight as to the probable outcome.

Even though most wanted Brazil to succeed, because the predicted outcome would probably lead to severe social uprising, and a Venezuela crisis that words can not begin to contemplate, most would come to the sad realization that Brazilians will look back at 2016 and realize what a funken mistake!

Fixed it for you

gespiri's picture

Maybe your parents said the same thing the year when you were born.

Pie rre's picture

I buy medical marijuana for neuropathy.  I prefer the capsules which are 10mg of THC and cost 2.50 each. It requires four for 6 hours of relief which translates to 3600.00 per year because the fucking taxes are so high. I could easily double the amount. I live in an apartment which doesn't allow smoking or growing otherwise I would grow my own. Dirty fuckers.

Chris Dakota's picture
Chris Dakota (not verified) bamawatson Mar 6, 2017 8:02 PM

My dog has seizures, he is now taking some marijuana drops which don't make him high (they say) it works for children.

Hope it works for my boy, my dog the best person I know.

I dug around and found out most Americans put the dog down after one seizure, the pukes that they are. They should be killed.

They even give their kids away to foster care if they have problems, so they can be more happy.

What a mess_man's picture

Even better give him some weed butter. Works great on cats too.

FireBrander's picture

Drugs for migrains/siezures have horrible, even deadly, side effects...but not pot...and pot is illegal because it's "dangerous".

John_Coltrane's picture

There's a old saying,
"the more people I know the more I like my dog"

A sage observation on which I concur as I'm sure you do.

JLee2027's picture

Break it into two votes. I dare the RINO's to refuse to repeal ObamaCare.

tip e. canoe's picture

great article, the doctors are a key cog in the scam that few seem to acknowledge.

on a side note, ever get a claim from your health insurance co. for a doctor's visit or lab work and wonder what all those line items are for?    how can anyone validate the legitimacy of the charges if you were the one getting the work done as there's absolutely no detail listed?

BurningFuld's picture

"People with per-exisisting conditions" or as other people would call them..."people".

new game's picture

pre-exisitng condition defined:the ones that use the most. lol, fuk that.

how about health insurance based on current health. like body fat, blood pressure, blood tests.

shit, they do it for life insurance. fuken joke.

slobs pay the most, simple shit maynard...

 

Joe Sichs Pach's picture

Exactly. It's this simple.
A la carte plans based on the coverage you want.
Take care of yourself and be rewarded.
Be a fat slob and pay to live that way.
NOT with my money.

FireBrander's picture

That's not going to work UNLESS we gut the COST OF CARE.

Before ObamaCare, I was paying $400 a month ($4800 year!) for the most stripped down fucking plan imaginable. $10,000 deductable, then 80/20 for next $5000, then 50/50 for the next $5000 then the ins paid 100%.

So, $16,500 out of pocket on top of $4800 in premiums...$21,300 a CALENDER YEAR!

I love this part...If on Dec 31st, my out of pocket was $16,499, on Jan 1st I'm back at zero...total fucking ripoff.

Viewed it as bankruptcy insurance; fortunately we're very healthy people.

Giant Meteor's picture

Long country doctors, a.k.a. "saw bones."

I mean, I am pleased that from all those amputations, back in the good ole days of the civil war, doctors came away with some new discoveries, wash hands in between surgeries, disinfect your cutting instruments, clean bandages, hot water etc. And lordy, just look at what they can do with gut shots, and brain trauma these days, once, a fairly guaranteed death sentence ...

But then, they got all uppity and shit, stopped accepting chickens, fresh apples and eggs as payment. Got no money? Ok that meat chicken will do just fine.

My point, hell I don't believe I had a point. Sometimes I just write crazy shit, so I can have a little sense of belonging on this ball of dirt .. usually, I snap out of it. Beats unrestrained rage I suppose.

Ok, carry on .. apologies for the interuption.

Good point btw ..