Despite Republicans’ nonstop talk about repealing and replacing the Affordable Care Act (ACA, or Obamacare), they have yet to present legislation to accomplish those goals. That doesn’t mean they haven’t been working on it. Politico obtained a draft of the bill. You can read all 106 pages of it here, but who has time to weed through that?
“It’s an unbelievably complex subject,” is how President Trump himself described it to the nation’s governors, according to CNN. “Nobody knew health care could be so complicated.”
Health care is expected to be one of many topics of discussion when Trump addresses a joint session of Congress Tuesday, February 28, at 9 p.m. ET.
But we’re not expecting a detailed analysis of the health care overhaul bill—at least not by Trump. What we do have at this point is a closer look of the leaked draft, thanks to STAT news, which broke down the legislation into five takeaways:
- It would overhaul Medicaid in significant ways. In fact, Medicaid expansion would be phased out, spending could be capped and individual states would have more control over what is covered. This could mean trouble for people with chronic conditions or who require newer, more expensive meds, such as the treatments for hepatitis C virus (HCV).
- It would end Obamacare’s mandate of what health insurance must cover. Under the proposal, states would decide what is covered. Health care advocates fear that mental health services and substance abuse treatment could be cut because, as STAT notes, “people with addiction issues are expensive to treat and therefore cover.”
- It would end the tax on pharmaceutical manufacturers. It also repeals taxes on health insurance plans, tanning beds and medical devices—money that, in the past, helped pay for Obamacare. STAT reports that to make up for the lost money, the draft bill would likely tax employer-based health insurance.
- It gives health plans more leeway to charge older people more. The draft bill does not allow health plans to discriminate against people because of preexisting conditions. Instead, older people may pay more. To ease this transition, the bill also gives older people a larger tax credit.
- It would repeal the Prevention and Public Health Fund. The bill does not include a replacement for the funds that go to prevention and public health activities.
Since this draft was leaked, several GOP Congress members have said they would not support it as is. “The draft legislation…risks continuing major Obamacare entitlement expansions and delays any reforms,” Representative Mark Walker said in a statement quoted in a different CNN article. “It kicks the can down the road in the hope that a future Congress will have the political will and fiscal discipline to reduce spending that this Congress apparently lacks.”
Representative Mark Meadows, chairman of the conservative House Freedom Caucus, told CNN he was against the refundable tax credits in the draft bill, describing them as a new “entitlement program.”
“So the headline is that the GOP is reducing subsidies to needy individuals when in fact, the growth of the taxpayer-subsidized reimbursements will actually increase. The total dollars that we spend on subsidies will be far greater,” Meadows told CNN. “So you can be a millionaire and not have employer-based health care and you're going to get a check from the federal government—I’ve got a problem with that.”
For a roundup of POZ articles on health care legislation, click #Obamacare.