Published: Mon, February 27, 2017
Medicine | By Daryl Nelson

House GOP Finally Puts Obamacare Repeal Plan on Paper

House GOP Finally Puts Obamacare Repeal Plan on Paper

Republicans say they expect to decide on a replacement for the present law in the coming weeks. It proposes cuts to federal payments to states that have expanded Medicaid and offers tax credits for people to buy health insurance.

The report estimates that coverage declines would be even higher in states that did not expand Medicaid - largely those run by Republican governors.

"Most of the Affordable Care Act, in the framework, is going to stay there: coverage for kids up to age 26, covering those with preexisting conditions".

Some 21 million people have gained coverage under the ACA, and contentious town hall meetings and marches are revealing what Republicans always feared: once people have a benefit, it is very hard to take it away. Republicans simply have not wanted to provide the financing necessary to get more health care to an overwhelmingly low-income, uninsured population. "This has been true in our population forever and it's true around the world", said Karen Pollitz, a senior health policy fellow at the Kaiser Family Foundation. The former speaker's frank comments capture the conundrum that many Republicans find themselves in as they try to deliver on pledges to axe Obamacare but struggle to coalesce around an alternative.

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Fifty-four percent of the 1,503 adults surveyed February 7 to 12 said they approve of former President Obama's signature health insurance plan, while 43 percent say they disapprove. But Republicans also plan to change Medicaid into a program of block grants to the states, with sharp reductions in federal funding. While Republicans have yet to agree on a detailed policy to replace Obamacare with, there is an interesting update regarding Medicaid. Two-thirds of respondents say Medicaid should continue to be funded as it is today. Then immediately form a replacement task force to put together the best parts of a replacement, drawing from the many attractive replacement bills submitted by members of Congress, some of whom were doctors. like Tom Price, newly confirmed Secretary of Health and Human Services. "I think realistically, if we do the process the right way, replacement is going to take a period of time". It will be interesting to see which is true, however, according to Bloomberg's Zach Tracer, older people may be the ones at the most risk to lose their coverage or pay more for it without Obamacare's help.

"Governors know about 50 times more about Medicaid than anyone in Congress", said Haley Barbour, the former Republican governor of Mississippi.

While the replacement plan would nix some of the unpopular aspects of Obamacare, including the individual mandate, it also seeks to get rid of provisions that could face heavy blowback. "But I can tell you there is a very strong consensus in the House that Obamacare is collapsing on the American people", he said, adding that deliberations on fixing health care issues are "moving very rapidly".

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