A Republican plan to overhaul the nation’s healthcare system is expected to be a major policy departure from past Republican efforts.
The House is set to vote on the GOP’s “Trumpcare” on Tuesday.
Here’s what you need to know about the GOP proposal.
It Would Allow the Government to ‘Decimate’ Healthcare Coverage According to the House’s version of the healthcare bill, the federal government would be allowed to “decimate” healthcare coverage by mandating that states implement Medicaid expansion and by forcing states to pay for all the care that goes to people who have preexisting conditions.
The bill would also require the states to “implement the ACA” — a term used to describe the healthcare law that is supposed to cover people with preexisted conditions.
“The ACA will require states to ensure that all Americans have access to affordable, quality health care and that states do not deny coverage to those who need it most,” the House version reads.
The goal of the bill is to “bring down health care costs by $9 trillion over 10 years.”
It also says that states must “exercise reasonable flexibility in setting up the individual market to allow consumers to access and shop for the best health plans.”
The bill calls for federal funding for states to set up a marketplace to allow people to buy insurance through the ACA, as well as a “health savings account” to help people save for their medical expenses.
States are supposed to make sure that insurers offer people the best insurance they can, but the bill says that federal mandates for coverage must be met and that insurers must not discriminate against people with pre-existing conditions.
The ACA Would Require States to Pay for All Healthcare Coverage The GOP plan also includes a mandate for states “to maintain adequate funding to pay all of the costs of coverage.”
That mandate, known as “essential health benefits,” is supposed not to apply to the ACA’s Medicaid expansion, but to the individual mandate that people buy insurance that covers their basic medical needs.
The Medicaid expansion covers about 20 million people in the US.
The mandate also applies to coverage for pre-emergent conditions like heart disease and diabetes, as long as they are covered by an insurer that is offered through the marketplaces.
In 2018, Congress passed a “continuing resolution” that funds the ACA.
That money is supposed come from a new tax on the rich called the “Tax Cuts and Jobs Act,” which was passed in 2018.
But that funding is not yet available to states, which must submit their plans for Medicaid expansion to the Department of Health and Human Services (HHS).
The bill also says the federal subsidies to help states enroll people in Medicaid expansion must be paid for through a new trust fund created by the ACA that is expected, according to the Congressional Budget Office (CBO), to be in the range of $15 billion to $20 billion.
The CBO says that $8.5 trillion is needed to pay the subsidies.
The GOP Plan Would Requiring States to Offer the Best Insurance Under the GOP plan, insurers would be required to offer plans that cover pre-existing conditions, including those with premedication, and to cover “the full range of coverage available in the marketplace.”
That includes a “skinny” option, which would cover the most expensive plan available in a given state, and a “high-risk” option that would cover less expensive plans.
The legislation would also set up the reinsurance program, which is supposed a way to provide insurance for people with high-risk pre-condition conditions.
Under the plan, reinsurance payments would be tied to how many people actually purchase insurance.
The reinsurance money would go to states through the reinsuring program and could be used to cover premium payments for people who do not purchase insurance through an insurer.
“Insurers would be able to offer higher-cost, high-quality plans that are lower risk, and that are offered by people who live in states that are low-risk,” the GOP says.
“That will make the market more affordable for the average American, not less.”
The Democrats Would Negotiate with Republicans About the Price of the ACA According to a Democratic source, the House bill includes a provision that would allow states to negotiate with insurers to reduce the price of plans that include coverage for people whose pre-conditions are pre-medication.
This provision, the source said, is a way for Republicans to say that the ACA doesn’t cover people who need pre-emptive care, but rather that the plan does.
Democrats are not expected to take up the legislation, as they have not voted on a similar proposal.
The Republican Party Has a ‘Biggest Problem’ with Healthcare Costs According to Politico, a Republican representative from Alabama who represents a district that includes Alabama said the GOP is “not really on the best track” to repeal the ACA and said the bill does not address the healthcare