A group of conservative House Republicans on Wednesday
unveiled an Affordable Care Act replacement plan that would increase access to
health savings accounts, expand federal support for states to establish
high-risk pools, and allow insurers to sell health plans across state lines.
The
184-page
bill, titled gThe American Health Care Reform Act of 2017,h also aims to
glevel the playing fieldh between those who get their insurance from employers
and those who purchase it individually by creating a standard tax deduction for
health insurance.
The legislation has been previously introduced without
much support from Republican leadership. But given the push to find a way to
replace the ACA, it could draw the attention of other House
Republicans
gObamacare, for all the talk of collapsing markets and
soaring premiums, has stripped individuals across this country from the most
important decision we may ever face, and that is the decision regarding our own
healthcare,h Rep. Mark Walker (R-N.C.), chairman of the very conservative
Republican Study Committee, which released the bill, said during a press
conference Wednesday. He later said the committee's plan is ground 1h in what's
likely to be a long battle to wrest health care decisions out of the hands of
bureaucrats.
The House Republicans released the plan following the
Senate's procedural vote earlier in the day that kicks off debate on a budget
resolution that will act as a vehicle to repeal the ACA. That bill was
introduced Tuesday just hours after members of the 115th Congress were sworn in.
Also on Wednesday, President Barack Obama and Vice President-elect Mike
Pence
visited Capitol
Hill to rally their parties for the ensuing battle over the health care law.
Taking aim at Democratic lawmakers who have said that Republicans will
repeal the ACA with no set replacement plan, Rep. Phil Roe (R-Tenn.), argued,
gThat's absolutely false. We have a plan.h Roe said he's gwilling to listen to
Democrat ideas about this, to amendments to this bill, as opposed to what they
did, which is completely shut the other side out.h
However, when asked
whether the committee aims to repeal and replace the ACA simultaneously, Walker
said the committee doesn't yet ghave the full timeline as far as replacement.h
Rep. Bill Flores (R-Texas) said those who have gained coverage under the ACA
could rest assured they would be safe during a transition.
Experts worry
that repealing the law without an immediate replacement
could collapse
the already struggling individual insurance market, leaving up to 30 million
without insurance.
The Republican Study Committee's plan is similar to
House Speaker Paul Ryan's replacement pitch. It also contains many of the same
components of a plan released by the committee in 2015.
The bill would
fully repeal all aspects of President Barack Obama's signature health care law
effective January 1, 2018, if enacted.
It emphasizes broad use of health
savings accounts, which have figured prominently in other conservatives'
proposals. Some experts question whether low-income people can afford to
contribute to HSAs to make them useful.
The plan would allow individuals
enrolled in Medicare or Tricare, or who get care from the Veterans Affairs or
Indian Health Service to use and contribute to HSAs. It also expands what
services can be purchased using HSA tax exempt funds, and increases the maximum
contribution people can make toward their HSA to an amount equal to the annual
limit of their out-of-pocket expenses.
The plan would, however, prohibit
people from paying for abortions with their HSA funds, except in certain cases.
The American Health Care Reform Act of 2017 also takes a bite out of the
tax provision that excludes employer-sponsored health benefits from income and
payroll taxes. Instead, it creates a standard tax deduction for health insurance
of $7,500 for individuals and $20,500 for family coverage.
g(That
standard deduction) will give families flexibility to pick coverage that best
fits their needs and ensure that the tax benefit for insurance doesn't go away
if you lose or change jobs,h the bill reads.
Employer groups would
likely
vehemently
challenge any proposal that would chip away at the tax exclusion, which has
allowed employers to sponsor insurance while reaping tax benefits. An estimated
155 million Americans get insurance through their employers.
The
committee's plan would also expand federal support to $25 billion over 10 years
to help establish state high-risk pools that would provide coverage for people
with preexisting conditions, as long as they maintain continuous coverage. It
would cap premiums in those plans to 200% of the average premium in the state.
And to promote competition, the legislation would allow insurers to sell
policies across state lines — once a favorite talking point of President-elect
Donald Trump. Insurance experts
question
whether the idea is feasible. Some say it would undermine state regulations
and lead to an unbalanced risk pool.
Finally, the bill also seeks to
reform medical liability law and expand wellness programs.