House GOP leadership filled in a few blanks on how it plans to replace Obamacare, in a policy brief sent to members Thursday morning.
The brief doesn’t provide specifics on the length of a transition period out of the Affordable Care Act, but it does say that during a transition people would be able to use its subsidies to buy cheaper plans that are currently prohibited, such as plans that provide catastrophic coverage.
During the transition period, the subsidies would be tweaked to be based more on a recipient’s age instead of income, as the current system operates.
The brief also indicates that House Speaker Paul Ryan and his team prefer to transition Medicaid to a per capita system instead of block grants, even though states could choose block grants if they wanted.
It also proposes to eventually provide Americans without employer-sponsored coverage with age-based, advanceable, refundable tax credits for buying health insurance, rather than the slimmer tax deductions that help only those earning enough to pay taxes.
That’s a key distinction, as some of the more conservative members dislike refundable credits, saying they’re a subsidy. But people can take advantage of deductions only when they’re filing their taxes, whereas credits would help them pay premiums month to month.
“Many Americans need help paying their monthly premiums,” the brief says. “They cannot afford to wait until they file their taxes the following year to get assistance. A system that allows for the delivery of financial help in ‘advance’ of tax filing is critical.”
The brief says Republicans will repeal all of the Affordable Care Act’s taxes, including its tax on health insurance premiums and medical devices and its increased expense threshold for deducting medical expenses, but doesn’t detail how the replacement’s expenses such as its tax credits would be paid for.
The bill also will include Hyde Amendment restrictions on federal funding for abortions during the transition period, the brief says.
House Republicans met Thursday morning to discuss Obamacare repeal and replace, but there is yet no legislative text. Committee leaders have said they plan to start marking up legislation next month.
