Republicans roll out Obamacare repeal and replace

Contributed By:The 411 News

If the House Republicans’ American Health Care Act, their version of the Obamacare repeal and replace legislation stands, the national debate over health care will continue.

Challenges from Democrats and critics of the Republican plan will surely escalate now that the Congressional Budget Office’s announcement Monday that 14.5 million Americans currently enrolled in a health plan would lose their coverage if the Republican plan were enacted next year. That is close to 75% of the 20 million Americans who gained health coverage under the Affordable Care Act, given the name Obamacare.

After 7 years of strong dissent against Obamacare and making repeal the centerpiece of election campaigning, Republicans are now in the driver’s seat with their promise to make health care better for everybody.

Some parts of Obamacare have been adopted by the AHCA. Insurance companies can’t deny coverage to those with pre-existing conditions and adult children can stay on their parents’ policy until age 26. And the Obamacare subsidies remain, but they’re called tax credits. Insurance plans must still provide the 10 essential benefits established by Obamacare

The Obamacare marketplace or exchanges remain. But the Republican plan lets enrollees use the tax credits outside of the exchanges whereas Obamacare doesn’t.

AHCA doesn’t require everyone to have health insurance, ending the Obamacare penalty individuals pay at tax time if they did not have health insurance. Getting rid of the insurance requirement, the budget office reported, will give more individuals an incentive not to sign up for health care.

The biggest changes by the AHCA come in its Medicaid funding. And this is where much of the enrollment loss will be seen.

Obamacare’s expansion of Medicaid coverage will end in 2020. Before the expansion, Medicaid only covered children, pregnant women, the disabled, and the elderly. Obamacare extended Medicaid coverage to low-income adults without children, giving health care access to some 11 million Americans who had not been able to afford health insurance on their own.

In 2020, Medicaid eligibility will return to its pre-expansion rules. The federal government will then distribute Medicaid dollars to the individual states based on the state’s current Medicaid population. The states will decide on who gets covered and the types of benefits.

The worry for some states that accepted the Medicaid expansion, 31 including Indiana, is will those funds be enough to cover the rising costs of health care. Currently, the federal government uses a formula to match how much it contributes to each states’ Medicaid costs.

Indiana’s HIP 2.0 – a version of the Medicaid expansion that currently enrolls about 400,000 Hoosiers – goes away after 2020. The Republican plan does stipulate that those who are covered under the expansion would continue to be funded by the federal government after that, but states would no longer be allowed to enroll anyone under the expansion criteria. An enrollee who loses eligibility for the expansion program could not re-enroll.

Gary Mayor Karen Freeman-Wilson expressed apprehension about the ability of the replacement bill to provide every American with affordable health care. As a member of the advisory board of the United States Conference of Mayors, Freeman-Wilson said a bipartisan letter signed by 130 mayors was sent to Congress.

“Many of the nation’s Mayors have expressed how significantly the proposed health bill will impact their cities and its residents. Among many challenges that would exist on the local level, The American Health Care Act proposes to cut state funding that would eliminate health care services for many families, seniors and those with disabilities. The USCM is strongly urging that the key provisions of the ACA remain a part of the new health care law.”

Republicans have insisted that Obamacare must be replaced because of its rising costs.

Story Posted:03/14/2017