Republicans unveiled their long-awaited legislation to repeal and replace the Affordable Care Act, proposing to phase out key parts of the law over several years as they try to break a stalemate between moderates and conservatives in their party.
Called the American Health Care Act, the House Republicans’ proposal includes a refundable, age-based tax credit to help people buy insurance. It ends Obamacare’s requirement to have coverage, and would eventually eliminate many taxes used to fund the 2010 law. Other changes, like a wind-down of an expansion of Medicaid, are phased in over a period of years.
It’s not clear whether the proposal can win the support of House conservatives or clear the Senate -- where Republicans hold a thin majority and are relying on a fast-track legislative procedure full of limitations. President Donald Trump, who has eschewed detailed policy proposals in favor of tweets and broad promises about better health care for less money, touted the plan Tuesday on Twitter: “Our wonderful new Healthcare Bill is now out for review and negotiation. ObamaCare is a complete and total disaster - is imploding fast!”
“Don’t worry, getting rid of state lines, which will promote competition, will be in phase 2 & 3 of healthcare rollout,” Trump added. He also said he was working on “a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down!”
Seven years after Republicans began promising repeal, the proposal is the most comprehensive look yet at how the GOP will approach replacing the health law, which brought coverage to an estimated 20 million people. Republicans have blamed the ACA for rising insurance premiums and high out-of-pocket costs, and criticized its requirement that everyone have health insurance or pay a penalty.
A CNN/ORC poll released Tuesday found that Americans are split over Obamacare’s mandate to obtain coverage or pay a penalty, with 50 percent opposed to removing the requirement, while 48 percent favor removal. Other recent opinion polls have shown rising support for the Affordable Care Act since Trump’s election.
Republican Splits
The proposal released Monday night represents an attempt to appease different factions within the Republican Party. Democrats were excluded entirely from the bill’s drafting, and have complained that it was written in secret.
While conservatives have pushed for full, immediate repeal, one concern among some moderate Republicans is that too-sudden changes would callously toss people out of coverage right away -- particularly those in Medicaid, the federal-state program for the poor that was expanded under Obamacare.
Estimates of how many people would be covered under the Republican plan in comparison to Obamacare are not yet available.