Magazine article Clinical Psychiatry News

House Republicans Unveil Long-Awaited Plan to Replace ACA

Magazine article Clinical Psychiatry News

House Republicans Unveil Long-Awaited Plan to Replace ACA

Article excerpt

Six years after promising a plan to "repeal and replace" the federal health law, House Republicans are finally ready to deliver.

The 37-page white paper, called "A Better Way," includes virtually every idea on health care proposed by Republicans going back at least 2 decades. It would bring back "high-risk pools" for people with very high medical expenses, end open-ended funding for the Medicaid program, and encourage small businesses to band together to get better bargaining power in 'Association Health Plans."

What the plan does not include, however, is any idea of how much it would cost, or how it would be financed. Also unclear is how many of the 20 million Americans who have gained coverage since the law took effect would be able to remain insured.

"It's a framework," a senior House Republican leadership aide said on a conference call with reporters, with the specifics to be determined next year by congressional committees, assuming the GOP maintains its majority. He likened the document to the white paper issued just after President Barack Obama's election by then-Senate Finance Committee Chairman Max Baucus (D-Mont.). That document foreshadowed many of the key elements of the Affordable Care Act.

The plan starts with repeal of the health law and its requirements and taxes, but it would then put back many of its most popular elements: allowing young adults to stay on their parents' health plan to age 26, banning insurers from charging people with preexisting health problems higher premiums, and forbidding insurers from dropping coverage if a policyholder gets sick.

It would repeal the current scheme of exchanges where consumers buy insurance and government tax credits to help moderate-income Americans pay their premiums if they don't have an employer to help. Instead, everyone buying policies in the individual market would receive tax credits. Older people charged more by insurers would receive larger credits, though the House Republicans don't specify how much.

But the GOP plan also would likely make insurance more expensive for older people by proposing a broader range for premiums based on age. Current premiums can vary only threefold based on age, which is "driving out younger and healthier patients" who can't afford them, the GOP aide said. …

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