Medicaid Tweaks
The changes to the bill give states another option for how their Medicaid payments from the federal government would be calculated. States could opt for block grant payments, instead of the per-person payment caps that were already in the measure. The so-called manager’s amendment would also repeal Obamacare’s taxes this year, one year earlier than originally planned.
Representative Chris Collins, a New York Republican, also told reporters Monday that leaders agreed to add a special provision to hold $2.3 billion a year in Medicaid funding from New York unless the state’s governor and state legislature agree to stop forcing counties to help pay for Medicaid. He said the change was needed to help persuade most New York Republicans in the House to back the measure.
The Medicaid provision is written to pertain only to New York counties outside of New York City, said Representative John Faso, a co-author.
The changes didn’t include an alteration some conservative GOP members sought to wind down Obamacare’s expansion of Medicaid starting in 2018 rather than in 2020 as was proposed in the original legislation.
Some moderate Republicans also wanted to increase tax credits for older, poorer people -- a demographic that would pay substantially more for health coverage under the GOP bill than under Obamacare. Those changes weren’t made in the most recent version, but part of the amendment leaves room for the Senate to increase the tax credits for that group.
Under the original legislation, older Americans would have been hit with significant increases in premiums without adequate financial assistance. This new pot of money is created by a tweak to the bill that lowers the amount Americans can deduct from their taxes for the cost of medical expenses that exceed 10 percent of their income. The threshold would shrink to 5.8 percent.
The Medicaid limits are an appeal to more conservative Republicans. Most members of the Freedom Caucus want to go further and make it mandatory in all states, a GOP aide said.
The caucus would also like to repeal insurance regulations instituted under the Affordable Care Act, often called Obamacare, that for example, require health plans to cover services known as essential health benefits, such as hospitalizations, prescription drugs and mental health services.
This article was provided by Bloomberg News.