A 105-page draft of the reconciliation bill, which will repeal and partially replace Obamacare, was leaked to the press Friday, showing Republicans plan to scale back Medicaid and eliminate penalties attached to the individual and employer mandates.
The discussion draft, leaked to Politico, calls for tax credits for individuals based on age, ranging between $2,000 and $4,000 — a shift from the Affordable Care Act (ACA), which bases subsidies on income.
States that opted to expand Medicaid during the Obama administration would gradually have the additional federal funds phased out until 2020. States would instead be provided a per capita cap, which would allocate money based on the number of those enrolled. Proponents argue it provides states with more flexibility while bringing down costs.
The bill aims to stabilize premiums while covering individuals with preexisting conditions by providing “State Innovation Grants.” The grants would provide states a total of $100 billion — $15 billion in 2018 and 2019 and $10 billion through 2026 — to deal with a broad number of issues.
While the mandate is being eliminated, the proposal grants insurers the ability to increase premiums by 30 percent if there is an extended lapse in coverage.
The bill would completely eliminate federal funding for abortion providers — a huge win for pro-life lawmakers.
Under Obamacare, premiums were capped at three times the cost of coverage for younger individuals; that would be upped five times under the new proposal.
Previously, those in individual health plans before Obamacare would eventually have to switch from their old plans onto a new exchange plan. The proposal includes language allowing insurers to offer grandfathered plans to permit people to keep their current plans.
To fund the changes, a tax would be imposed on high-end, employer-sponsored plans that fall in the 90th percentile of premiums. The provision will likely be controversial with conservatives, who were highly critical of the ACA’s “Cadillac tax.”
The bill is expected to be introduced shortly after Congress returns from recess.