From ‘Repeal’ to ‘Repair’: Campaign Talk on Health Law Meets Reality

https://www.nytimes.com/2017/02/06/us/politics/obamacare-tom-price-trump.html?ref=todayspaper


Good article . . .

Thanks, knot. Will try to get to that one today.

Meanwhile, most of y'all probably know there'll be a televised town hall debate tonight (Feb. 7) about the future of healthcare, between Bernie Sanders and Ted Cruz, moderated by Jake Tapper and Dana Bash. CNN, 9 Eastern.

If I can stand listening to Cruz, and if I can stay awake (bad head cold), I'll try to watch.

RealLindaL wrote:Thanks, knot.  Will try to get to that one today.  

Meanwhile, most of y'all probably know there'll be a televised town hall debate tonight (Feb. 7) about the future of healthcare, between Bernie Sanders and Ted Cruz, moderated by Jake Tapper and Dana Bash.  CNN, 9 Eastern.

If I can stand listening to Cruz, and if I can stay awake (bad head cold), I'll try to watch.

Frankly I had forgotten so thanks for the heads up and I totally agree with your comment about Lyin Ted . . . . .

Good to know you'll be watching, knot.

The propaganda was so effective that in some states people were on ACA policies, but they complained about Obamacare, and did not realize the great health plan that they could afford and were getting subsidized.........was Obamacare. The skilled spam and propaganda which flooded this country was directly responsible for Americans being harmed in this election cycle. Thankfully the spam generator was extracted here, but the sad thing is that he will be spewing evil on other forums.

RealLindaL wrote:Good to know you'll  be watching, knot.  

http://money.cnn.com/2017/02/14/news/economy/humana-obamacare-insurer/index.html

The Obamacare exodus has begun.
Humana (HUM) announced it is pulling out of Obamacare for 2018 on Tuesday, the same day it ended a merger agreement with Aetna (AET).
It's the first major insurer to exit Obamacare under President Trump, who has promised to repeal the law.
The company said in a press release it has tried for the past several years to keep selling policies where it could offer "a viable product." It said it increased premiums, exited markets and tightened provider networks in hopes of stabilizing its individual market business.
But an initial analysis of its 2017 consumer base found that it remained riskier than Humana could tolerate. So the company is exiting all 11 states where it sells individual policies, both on the Obamacare exchange and outside of it.
Related: Insurers warn: We're outta here with no Obamacare replacement
The company said it will continue to service its current policyholders throughout the rest of the year.
Humana was among several major insurers to pull back from Obamacare this year, after having to pay higher-than-expected claims for its patients. The Louisville, Kentucky-based insurer stopped offering coverage in eight states and nearly 90% of the counties where it operated in 2016.
Related: Aetna-Humana & Anthem-Cigna: Two mergers die in one day
Insurers have also grown increasingly jittery as Congressional Republicans remain divided over how to repeal and replace Obamacare. Several large carriers -- and the industry's lobbying group -- have warned that they will leave unless lawmakers provide more clarity about their plans for the health reform law.

http://finance.yahoo.com/news/trump-administration-just-proposed-massive-145438220.html

The Trump administration just proposed big changes to Obamacare

The Centers for Medicare and Medicaid Services on Wednesday morning announced new proposed rules for the Affordable Care Act's individual insurance exchanges.
The proposals from CMS include several changes to enrollment periods and timelines for insurers in an attempt at "stabilizing the individual and small group health insurance markets," according to a press release.
The proposed changes would be the first administrative tweaks to the law, also known as Obamacare, under President Donald Trump's administration. They contain a combination of long-considered ideas and serious departures from the previous administration.
Perhaps the two most striking proposed changes are cutting in half the exchanges' 2018 open enrollment period and lowering minimum standards for care to qualify for the exchanges.
The CMS proposes an open enrollment period — during which people without health insurance through their employer or Medicaid/Medicare can sign up for coverage — from November 1 to December 15, 2017. Open enrollment periods have been three months, from November 1 to January 31.
Additionally, the rules would lower the "de minimis range used for determining the level of coverage," according to the release. Essentially, the ACA established minimum standards for coverage (here's a full breakdown from CMS) in order to be certified on the bronze, silver, and gold plan levels. The new rule would allow insurers to cover slightly fewer areas of health and still be at a certain metal level.
The CMS projects the rules would result in increased out-of-pocket costs for Americans in the short term but that lower premiums would offset this in the long run.
"The proposed change in [actuarial value] could reduce the value of coverage for consumers, which could lead to more consumers facing increases in out-of-pocket expenses, thus increasing their exposure to financial risks associated with high medical costs," the proposal says. "However, in the longer run, providing issuers with additional flexibility could help stabilize premiums, increase issuer participation and ultimately provide some offsetting benefit to consumers."
Patrick Conway, the acting CMS administrator, said: "This proposal will take steps to stabilize the marketplace, provide more flexibility to states and insurers, and give patients access to more coverage options. They will help protect Americans enrolled in the individual and small group health insurance markets while future reforms are being debated."
Here's a quick rundown of some of the other proposed changes:
Give insurers more time to figure out their 2018 plans. Insurers have expressed concerns about the uncertainty regarding the repeal and replacement of the ACA planned by Republicans. This uncertainty, coupled with enrollment data, has already led one of the largest insurers — Humana — to announce plans to leave the market. Others are considering their offerings. Insurers must submit 2018 plans to the federal and state governments in April. The proposal says that if the other changes are accepted, CMS would issue "separate guidance" on the deadline for insurers.
Increase scrutiny during special enrollment periods. The rules would force people who enroll outside of the open enrollment period to provide additional documentation to be allowed access to coverage. It would allow people who lose employer coverage because of a job status change to gain access, and it would prevent people from waiting until they get sick to sign up for a plan. This has long been an idea to prevent abuse of the special enrollment periods; the Obama administration had proposed something similar.
Force beneficiaries to pay back owed premiums before getting the next year's coverage. The rules would allow insurers to "to collect premiums for prior unpaid coverage" before the person can sign up for a plan from the same insurer for the next year.
Some of these changes were proposed by the Obama administration in August to address the imbalance in the exchanges.
The open-enrollment tweak may be the most significant departure from the Obama era, however. The CMS rules proposed in August tried to expand outreach and sign-ups for the open enrollment period, allocating more money toward advertising efforts. Trump's team pulled back from a good portion of a $5 million ad buy for the 2017 open enrollment period.
A shortened open enrollment period could also make it much more difficult to increase sign-ups or keep the number of people enrolled at the same level in 2018. The number of people who signed up during the open enrollment period fell in 2017 from the year before, mostly because of a significant deceleration in sign-ups after Trump took office.
The new proposed rules drew some criticism from health-policy experts. Larry Levitt, a senior vice president at the health-policy think tank Kaiser Family Foundation, tweeted that the rules "strike me as making things less consumer friendly and more insurer friendly."
The proposed changes are open for public comment until March 7, according to filings with the Federal Register.

http://www.vox.com/policy-and-politics/2017/2/23/14714282/john-boehner-obamacare-repeal?yptr=yahoo

Former House Speaker John Boehner says he started “laughing” when he heard the GOP’s plan to swiftly repeal and replace Obamacare. “Republicans never ever agree on health care,” he said in comments first reported by Politico.

And here’s the kicker. “Most of the framework of the Affordable Care Act … that’s going to be there,” Boehner said. He went on to say that he thought everyone covered by Medicaid now would keep their Medicaid coverage.

Ouch.

I’ve seen some react with fury to these comments. Didn’t Boehner hold repeal vote after repeal vote? Didn’t he win back the House in 2010, and hold it thereafter, promising to repeal Obamacare? Didn’t he participate in the government shutdown over Obamacare in 2013?

He did. But to interpret Boehner generously, Obamacare is in a very different place now than it was in 2010, 2012, or even 2013. It’s delivering benefits to about 30 million people. Dozens of states have built budgets around Medicaid dollars flowing in from the federal government. Health systems nationwide have reorganized themselves around its provisions.

It was plausible, if Republicans had won Congress in 2010 and won the presidency in 2012, that repeal and replace — or at least repeal — might happen. At that point, the law’s main insurance expansion hadn’t even begun. But now it has, and so that ship has sailed.

Repeal and replace worked in 2012. It doesn’t work in 2017.
In early January, Yuval Levin, who is deeply plugged in with Republican legislators, wrote a guide to the GOP’s repeal-and-replace strategy. The most interesting point Levin made was how much of it, even today, remains based on plans that Mitt Romney’s team drew up in 2012 — plans drawn up at a very different point in the Affordable Care Act’s life cycle:

The movement to repeal and replace Obamacare was born with 2012 in mind. Obamacare was enacted in 2010 but would not take full effect for four years, and there was a presidential election in the middle of that period. The idea was that if Republicans won in 2012, they would move swiftly to unravel the law before it took effect and then move more slowly and incrementally to enact conservative reforms that would enable a genuine consumer market in coverage for individuals.

The Romney transition team in 2012 developed a detailed strategy for such a two-step approach (including plans for an early repeal-by-reconciliation bill if Republicans took over the Senate). They effectively locked it away in a glass box marked “break in case of Republican president” – and left it unbroken in 2012. But after Trump’s unexpected victory, the first instinct of some Capitol Hill Republicans was to break the glass and get going.
In this telling, Republicans had a message for 2010, and a plan for 2012, and then when Barack Obama won reelection and the Affordable Care Act began delivering benefits, they didn’t revisit either. So now they’re adrift. Their 2012 plan doesn’t make any sense in 2017.

Boehner, who was there when the strategy was developed and also realizes the ways the world has changed, isn’t revealing that repeal and replace was always a con, but he admits it has now become one.

It’s worth noting one other thing Boehner said: “Republicans never ever agree on health care.”

This is a more important point than people realize. Democrats did years and years of work in advance of Obama’s presidency to come to a rough agreement on health care. Republicans haven’t done that work. They know they loathe Obamacare, but they don’t even agree on which parts of it they loathe.

At this point, the House Freedom Caucus has laid down the principle that any replacement must repeal the Medicaid expansion, while a critical number of Republican senators have said that any replacement must keep the Medicaid expansion, or at least its coverage and funding. Both sides would probably say they agree on repealing Obamacare. But they don’t even agree on what that means — which suggests they’re far, far away from agreeing on what a new health system would look like in its place.

And this is where the 2012-versus-2017 distinction becomes so important. A party that doesn’t have a health care plan might be able to repeal Obamacare before it exists — in that case, you’re simply replacing the status quo with the status quo. But it can’t repeal Obamacare after it exists, because that would mean replacing the status quo with complete chaos.

Watch: Republicans have a major problem on Obamacare

President Obama left a clear message for democrats in congress.....do not lift a hand to dismantle and replace. Without them, they can only destroy people's lives. When Republicans do not give a chit about Americans, we are getting to the essence of the special interests which control Congress.

http://www.npr.org/sections/health-shots/2017/02/22/516465156/gop-seeks-reduction-in-health-law-s-10-essential-benefits?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=20170222

GOP Considers Trimming Health Law's 10 Essential Benefits

As Republicans look at ways to replace or repair the Affordable Care Act, many suggest that shrinking the list of services that insurers are required to offer in individual and small group plans would reduce costs and increase flexibility.

That option came to the forefront last week when Seema Verma, who is slated to run the Centers for Medicare & Medicaid Services in the Trump administration, noted at her confirmation hearing that coverage for maternity services should be optional in those health plans.

Maternity coverage is a popular target and one often mentioned by health law critics. But other items also might be watered down or eliminated in the GOP revision.

There are some big hurdles, however. The Affordable Care Act requires that insurers who sell policies for individuals and small businesses cover at a minimum 10 "essential health benefits," including hospitalization, prescription drugs and emergency care, in addition to maternity services. The law also requires that the scope of the services offered be equal to those typically provided in the coverage that businesses offer their employees.

"It has to look like a typical employer plan, and those are still pretty generous," says Timothy Jost, an emeritus professor at Washington and Lee University Law School in Virginia who has studied and written about the health law.

Since the 10 required benefits are spelled out in the Affordable Care Act, the law would have to be changed to eliminate entire categories or to make them less generous than typical employer coverage. And since Republicans likely cannot garner 60 votes in the Senate to do that, they will be limited in changes that they can make to the ACA. Still, there's room to "skinny up" the requirements in some areas by changing the regulations that federal officials wrote to implement the law.

Habilitative services

The law requires that plans cover "rehabilitative and habilitative services and devices." Many employer plans don't include habilitative services, which help people with developmental disabilities such as cerebral palsy or autism maintain, learn or improve their functional skills, via speech or occupational therapy or other support services. Federal officials issued a regulation that defined habilitative services and directed plans to set separate limits for the number of covered visits for rehabilitative and habilitative services. Those rules could be changed.

"There is real room for weakening the requirements" for habilitative services, says Dania Palanker, an attorney and assistant research professor at Georgetown University's Center on Health Insurance Reforms, who has reviewed the essential health benefits coverage requirements.

Oral and vision care for kids

Pediatric oral and vision care requirements, another essential health benefit that's not particularly common in employer plans, could also be weakened, says Caroline Pearson, a senior vice president at the consulting firm Avalere Health.

Mental health and substance use disorder services

The health law requires all individual and small group plans to cover mental health services and treatments for substance use disorders. In the regulations, the Obama administration said that means those services have to be provided at "parity" with medical and surgical services, meaning plans can't be more restrictive with one type of coverage than the other regarding cost sharing, treatment and care management.

"They could back off of parity," Palanker says.

Prescription drugs

Prescription drug coverage could be tinkered with as well. The rules currently require that plans cover at least one drug in every drug class, a standard that isn't particularly robust to start with, says Katie Keith, a health policy consultant and adjunct professor at Georgetown Law School. That standard could be relaxed further, Keith says, and the list of required covered drugs could shrink.

Preventive and wellness services and chronic disease management

Republicans have discussed trimming or eliminating some of the preventive services that are required to be offered without cost sharing. Among those is covering birth control without charging women anything out of pocket. But, Palanker says, "if they just wanted to omit them, I expect that would end up in court."

Pregnancy, maternity and newborn care

Before the health law passed, just 12 percent of health policies available to a 30-year-old woman on the individual market offered maternity benefits, according to research by the National Women's Law Center. Those policies that did offer such benefits often charged extra for the coverage and required a waiting period of a year or more.

The essential health benefits package plugged that hole very cleanly, says Adam Sonfield, a senior policy manager at the Guttmacher Institute, a reproductive health research and advocacy organization.

"Having it in the law makes it more difficult to either exclude it entirely or charge an arm and a leg for it," Sonfield says.

Maternity coverage is often offered as an example of a benefit that should be optional, and that's what Verma has advocated. If you're a man or too old to get pregnant, critics of the requirement say, why should you have to pay for that coverage to be included in your policy?

But that a la carte approach is not the way insurance is designed to work, says Linda Blumberg, a senior fellow at the Health Policy Center at the Urban Institute. Women don't need prostate cancer screening, she points out, but they pay for the coverage anyway.

"We buy insurance for uncertainty and to spread the costs of care across a broad population so that when something comes up, that person has adequate coverage to meet their needs," Blumberg says.

*************

Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. Follow Michelle Andrews on Twitter: @mandrews110.

Health care in this country = Big medicine & Big pharma getting rich off of our misery.

panhandler wrote:Health care in this country = Big medicine & Big pharma getting rich off of our misery.  

And they do these things via collusion with govt. What's that called?

And they do these things via collusion with govt. What's that called?


Well spent lobbyist money. For 125 million of advertising supporting the ACA, Big Pharm got a ten year hands off on government negotiations to the Canadian and European pricing.......100 fold return on their investment, with full knowledge that they can pour the ill gotten profit to fight any attempt to bargain for the same rates as Europe and Canada in the next few years. Although health care inflation has dropped like a rock since the ACA, it will take a full fledged war with big Pharm to bring health care costs down.

You can't bring yourself to call it what it is. Try to come to terms with that... words and objectivity matter.

https://www.manhattan-institute.org/html/will-repealing-obamacare-kill-people-10044.html

The best statistical estimate for the number of lives saved each year by the Affordable Care Act (ACA) is zero. Certainly, there are individuals who have benefited from various of its provisions. But attempts to claim broader effects on public health or thousands of lives saved rely upon extrapolation from past studies that focus on the value of private health insurance. The ACA, however, has expanded coverage through Medicaid, a public program that, according to several studies, has failed to improve health outcomes for recipients. In fact, public health trends since the implementation of the ACA have worsened, with 80,000 more deaths in 2015 than had mortality continued declining during 2014–15 at the rate achieved during 2000–2013.

KEY FINDINGS

The Affordable Care Act has led to substantial increases in Medicaid enrollment but shows no effect in the aggregate on private insurance coverage; a lower share of non-elderly Americans had private insurance in 2015 than at the start of the recession in 2007–08.

Economic recovery, not the ACA, has driven changes in private insurance coverage: during 2007–10, total employment fell 5.5% and private insurance coverage fell 7.0%; during 2010–15, total employment rose 8.8% and private insurance coverage rose 9.5%.

The share of non-elderly Americans with private health insurance fell from 66.8% in 2007 to 65.6% in 2015.

By contrast, the share of non-elderly Americans enrolled in public insurance, primarily Medicaid, has increased from 18.1% in 2007 to 25.3% in 2015, accounting for the entire reduction in the uninsured share of the population.

Studies showing positive effects from health-insurance coverage focus on private insurance, not Medicaid.

In Oregon, researchers studied the effects of expanding Medicaid coverage and found no improvement in health out- comes. Numerous other studies support this finding for specific conditions and procedures, for Medicaid expansions and for public health spending generally.

Where studies do find that Medicaid has a positive effect, it is for pregnant women and young children— groups whose coverage was not expanded by the ACA.

A statistical claim that the ACA saves large numbers of lives should be supported by evidence that it has reduced mortality rates; yet the opposite occurred.

In 2015, age-adjusted mortality rose and life expectancy declined in the United States for the first time since the early 1990s.

Nor is it the case that states adopting the ACA’s optional Medicaid expansion performed better than those rejecting it; to the contrary, mortality in 2015 rose more in Medicaid expansion states.

Despite implementation of the ACA, there were 80,000 more deaths in 2015 than had mortality continued to decline during 2014–15 at the same rate as during 2000–2013.

READ FULL REPORT

I have a pdf copy of the new proposed plan that is going to be unveiled either this coming week or next week. Can't upload it here. Right now it's just short of 200 pages. All in all it looks to me to cost just as much if not more than obamacare. For pkr: won't exactly have the individual mandate but close enough. lol

The only thing that can lower rates for a decent plan is to get rid of the essential health benefits or make them ala carte.

The puck has moved..............

http://www.modernhealthcare.com/arti...n=financedaily

http://www.politico.com/f/?id=000001...b-78ff707e0000

Leaked House GOP draft offers first look at ACA repeal details
By Harris Meyer | February 24, 2017
(Story updated at 4:25 p.m. ET)

A leaked draft of the House Republican bill to repeal the Affordable Care Act would end the Medicaid expansion by 2020, spend a much larger than expected amount of money on state high-risk pools, and create premium tax credits offering 60-year-olds just twice as much as 30-year-olds.

The bill would convert Medicaid from an open-ended entitlement program to a program of capped federal contributions to the states based on the number of people enrolled, with payments rising by a fixed percentage regardless of medical cost growth.

In addition, it would repeal all the ACA's taxes that finance the law's premium subsidies, Medicaid expansion, and Medicare benefit enhancements. In their place, the bill would establish a new tax on employees for the value of generous employer health benefits. It would hit plans at and above the 90th percentile of current premiums. That idea is deeply unpopular with business groups and labor unions.

The “discussion draft,” dated Feb. 10 and obtained by Politico, is certain to draw criticism from both Republicans and Democrats. House Speaker Paul Ryan has said he wants to present an ACA repeal bill as early as next week and pass it through the expedited budget reconciliation process on a straight party-line vote before the Easter recess in early April. But he almost certainly will face strong objections from Democrats, state elected officials, healthcare industry groups, patient and consumer groups, and conservatives in his own party.

The draft likely is undergoing changes. That may be because insiders say the Congressional Budget Office has scored the bill as causing large increases in the nation's uninsured rate, which would rattle more moderate congressional Republicans who are nervous about causing millions of people to lose coverage.

Starting in 2020, the House bill would establish refundable premium tax credits based on age, unlike the ACA's income-based credits. People under 30 would receive $2,000, while people over 60 would get $4,000. Both low-income and high-income people would get the same amount.

The bill would eliminate the ACA's minimum essential benefit package and leave it up to each state to regulate benefit levels.

Experts said that while that level of tax credit might be large enough to cover the premium of a comprehensive health plan for a 30-year-old, it probably wouldn't be enough to cover the premium for a 60-year-old.

A differential of 2-1 in credits for older and younger people seems inconsistent with the push by insurers to increase the permitted premium differential based on age to 5-1, up from the 3-1 differential allowed by the ACA. Insurers say older people have medical costs that are at least five times as great as younger people.

“The credit in the House Republican bill would be plenty adequate at age 30 but pretty inadequate above age 60, particularly for people with lower incomes,” said John Holahan, a health services researcher at the Urban Institute. “I'm not sure why they picked those numbers.”

To address the issue of covering people with costly pre-existing medical conditions, the House bill would offer states $100 billion in “state innovation grants” over nine years to set up high-risk pools and other mechanisms for insuring such folks.

That's much more than the $25 billion House Republican leaders proposed last year in their Better Way white paper. But it still might not be enough to provide solid, affordable coverage to those with pre-existing conditions, given that previous estimates have pegged the annual public cost of running adequate high-risk pools at $15 billion to $25 billion a year.

“Over 10 years, a reasonably good high-risk pool would cost more than that,” Holahan said. “And is that $100 billion a one-time thing to help the states set up the pools, and then states are on the hook? We don't know. We need more details on how this will be structured.”

The bill would replace the ACA's tax penalty for not buying insurance with a 30%, one-year premium penalty on people who apply for insurance after letting their coverage drop. It's not clear insurers will consider that a strong enough incentive to pressure younger, healthier people to buy insurance, offsetting the costs of older, sicker enrollees.

One of the most politically explosive features of the legislation is the conversion of Medicaid into a capped federal contribution model.

“A per capita cap would result in huge losses of funds to states that will cause people to get fewer benefits, force beneficiaries to pay more out of pocket, and significantly reduce payments to providers, thereby causing many providers to shun serving beneficiaries,” said Ron Pollack, executive director of the pro-ACA advocacy group Families USA.

“The Senate won't swallow the Medicaid cuts,” said Tom Miller, a conservative health policy expert at the American Enterprise Institute.

Healthcare industry groups undoubtedly will demand many more details about the legislation before taking a position on it. Congressional Republicans repeatedly have promised that they would use an open and inclusive process, with plenty of hearings and opportunities for input, before passing ACA repeal-and-replace legislation. Their process, they have said, will contrast sharply with the way Democrats passed the ACA.

But experts say it will be nearly impossible to have a full debate on the Republican bill if GOP leaders stick to the lightning timetable they've laid out. Great for OFF exchange, and healthy, and younger people. Older low income get shaft.

“It's a legitimate point, how transparent will this be,” said Chris Condeluci, a Republican lobbyist who served as a Senate GOP staffer during the passage of the ACA. “It's not that people don't know what will be included. But will they go through the regular order of hearings? No.”

Adding to the Republicans' headaches, a new Kaiser Family Foundation survey found that more Americans now view the ACA favorably than unfavorably, 48% to 42%.

In addition, the vast majority (84%) say it is either “very” or “somewhat” important for any replacement plan to ensure that states that received federal funds to expand Medicaid continue to receive those funds. On top of that, 66% prefer to keep the current financing structure of Medicaid, compared with 31% who favor the per-capita approach.
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Who is angry with this:

Old people (AARP)
The bottom 40%, who don't care about tax credits
Carriers
Big Business
Labor Unions
Sick people
People who want to retire
States who don't want Feds telling them what to do

Who IS happy with this?

Where is the $100 Billion for the high risk pools coming from? They just got rid of the taxes to pay for it.

And did I miss the part of how rates were going to go down???

John Oliver very funny.

The much awaited for replacement plan has arrived:

http://thehill.com/policy/healthcare/322609-gop-releases-bill-to-repeal-and-replace-obamacare

House Republicans on Monday unveiled their long-awaited legislation to repeal and replace ObamaCare.

The two measures dismantle the core aspects of ObamaCare, including its subsidies to help people buy coverage, its expansion of Medicaid, its taxes and its mandates for people to have insurance. (READ THE BILLS HERE AND HERE.)

In its place, Republicans would put in place a new system centered on a tax credit to help people buy insurance.

That tax credit would range from $2,000 to $4,000 a year, increasing with someone’s age. That system would provide less financial assistance for low-income and older people than ObamaCare, but it could give more assistance to younger people and those with higher incomes.

Democrats warn that between the phasing out of ObamaCare’s Medicaid expansion and the smaller tax credit for poorer people, the 20 million people who gained coverage in recent years will be put at risk.

Republicans acknowledge that their plan will cover fewer people, saying unlike ObamaCare, they are not forcing people to buy coverage. They say their system is less intrusive and provides people a tax credit without mandates or a range of tax increases.

House committees are expected to vote on the measures this week, with the full House voting on it soon after that.

House Ways and Means Committee Chairman Kevin Brady (R-Texas) said Monday on Fox News he's confident the bill will pass with full Republican support despite recent party infighting over the details.

"We've been listening very carefully to our Republican members for months now to make sure we get it right," he said. "I am confident we are going to pass this." He noted that many of the elements of the bill have passed the House "a number of times" over the years.

The measure faces a rocky path, particularly in the Senate. Four Republican senators earlier Monday objected to an earlier version of the House bill, saying that it failed to protect ObamaCare’s Medicaid expansion.

But under the bill, the repeal of the Medicaid expansion would not take effect until 2020, and Republicans would grandfather in current enrollees so that they can stay on the program. But once 2020 arrives, the federal government would no longer provide the extra federal funds that allow for expansion.

That plan has drawn objections from more centrist Republican senators, who want to protect the expansion and are worried about constituents losing coverage and their states losing federal funds.

Even in the House, there are objections to the plan. Conservatives in the House Freedom Caucus call the bill's tax credit is a “new entitlement.” They have enough votes to kill the bill, but it remains to be seen whether they will actually vote against it.

The bill would maintain ObamaCare’s protections for people with pre-existing conditions, who could still not be denied coverage. Instead of ObamaCare’s mandate, the bill would seek to encourage healthy people to sign up by allowing insurers to charge people 30 percent higher premiums if they have a gap in coverage.

The measure also repeals ObamaCare’s taxes, such as the medical device tax and health insurance tax, starting in 2018.

The bill scraps a controversial Republican proposal in earlier drafts to start taxing some employer-sponsored health insurance programs. Instead, the measure would keep ObamaCare’s "Cadillac tax" on generous healthcare plans starting in 2025 in order to prevent that legislation from adding to the deficit in that decade.

Jessie Hellmann contributed.

If you want to read the complete bills you will have to go to the link and scroll down to where it says view the bills here. There are two.

Tax credits require that a person owes taxes.......if you owe taxes, you are making money. Poor people are going to be shafted, but I will give the benefit of the doubt and read it this week.

The tax credit is largely just a reworded subsidy. I am glad that the mandate is ended. I also don't think that the Medicaid expansion can be rolled back... but we'll see.

2seaoat wrote:Tax credits require that a person owes taxes.......if you owe taxes, you are making money.  Poor people are going to be shafted, but I will give the benefit of the doubt and read it this week.

Whether or not you read it, the fact remains that your first sentences are correct. Tax credits are WORTHLESS for people who pay little or no taxes. It's a crock, and the whole thing is going to throw millions of people back into emergency rooms as uninsureds, raising costs for the rest of us. This is a backwards step, pure and simple.

RealLindaL wrote:

2seaoat wrote:Tax credits require that a person owes taxes.......if you owe taxes, you are making money.  Poor people are going to be shafted, but I will give the benefit of the doubt and read it this week.

Whether or not you read it, the fact remains that your first sentences are correct.  Tax credits are WORTHLESS for people who pay little or no taxes.  It's a crock, and the whole thing is going to throw millions of people back into emergency rooms as uninsureds, raising costs for the rest of us.  This is a backwards step, pure and simple.

In other words a regressive step. Regressive is what they are all about.