Republicans rush Obamacare repeal-and-replace through House committees

“We are concerned that any poorly implemented or poorly timed change in the current funding structure in Medicaid could result in a reduction in access to life-saving health care services”, they wrote, in response to draft proposals from House Republicans. They tried unsuccessfully to insert language pressuring President Donald Trump to release his income tax returns, and failed to prevent Republicans from restoring insurance companies’ tax deductions for executive salaries above $500,000 – a break Obama’s law killed.

It only took seven years, but Republicans have finally decided how they want to replace Obamacare: with a much, much less generous version of it that nearly seems created to push individual insurance markets into death spirals. “If they have 218 votes, we won’t get any change”.

It’s not surprising that some of Obamacare’s most popular provisions aren’t touched. Mulvaney, a former Freedom Caucus member, talked with the group on behalf of the Trump administration, but Representative Mark Meadows said he didn’t tell them they had to back the AHCA. “We know that if we just repealed it, the system collapses”. Those buying plans on the individual market are eligible, but those covered through their jobs or the government are not.

An age-rated credit provides much greater incentive for firms to drop coverage, because all workers, not just low-income ones, can qualify for the credit.

It would also replace income-based subsidies to help with the cost of premiums with age-based tax credits. An enrollee making more than $47,500 does not qualify for assistance under Obamacare.

The criticism on Tuesday came even before lawmakers knew the cost of the replacement plan and how many people might lose their healthcare if it were enacted.

On Friday, Politico reported that Republicans were considering ways to amend their Obamacare “replacement” legislation, by placing income limits on the bill’s new refundable tax credit for health insurance.

And it repeals the mandate that larger employers must offer insurance to their employees. For example, it repeals a tax on medical devices and prescription medications, and delays the “Cadillac Tax” on high-cost employer health plans until 2025.

That’s because the Republican proposal takes a simpler, across-the-board approach to tax credits than the current law.

Those taxes paid for Obamacare.

Speaker of the House Paul Ryan, House Energy and Commerce Committee Chairman Greg Walden and House Majority Leader Kevin McCarthy hold a news conference about the proposed American Health Care Act outside Ryan’s office in the U.S. Capitol March 7, 2017.

The mandate’s goal is to draw young and healthy Americans – who might not feel they need coverage – into the market.

The first is that the Affordable Care Act is a misnomer ― in other words, it doesn’t really provide “affordable care” ― because the newly insured on Medicaid can’t find doctors who will see them, and the ones with private coverage are stuck with high out-of-pocket costs that make even modest medical treatment prohibitively expensive.

Since Republicans have said they want to protect those with pre-existing conditions, lawmakers must find a way to get these young and healthy consumers to buy policies.

In a letter to Congress, hospital groups, including the American Hospital Association, warned that the proposal is likely to substantially reduce the number of Americans able to afford health insurance or maintain coverage under Medicaid. How’s that? The answer is that the Republicans would let insurers hit people with a 30 percent surcharge if they do let their coverage lapse longer than two months.

All these provisions don’t sit well with conservatives.

The tax credits would be available in full to people earning less than $75,000 and households earning less than $150,000, but would be reduced for those who earn more.

“This plan does not fix the Affordable Care Act – it would just delay the Republican plan to cut coverage for almost a million Pennsylvanians, including those who were able to access quality, affordable health care after I expanded Medicaid two years ago”.