Conservative groups release Obamacare repeal plan

The block grant would repeal Obamacare’s premium subsidies and Medicaid expansion. A state can continue the expansion if it wants through the block grant.

At least 50 percent of the block grant, however, must go toward supporting people’s purchase of private health coverage, and at least 50 percent go to provide coverage for low-income people. An outline of the plan notes that the two categories will likely overlap.

The plan also requires a portion of the grant to “offset costs of high-risk patients.” This is a nod to protection for people with pre-existing conditions.

Obamacare forbids insurers from denying coverage to people with pre-existing conditions or charging them higher premiums.

Under the group’s plan, a state that gets block grants would not have to abide by Obamacare’s requirements for covering essential health benefits like maternity care or mental health.

States also don’t have to meet a requirement for a single risk pool that combines people with pre-eixsting conditions and healthier people.

“Nullifying these mandates along with new flexibility to the states would reduce premiums, allow fairer premium variation and, in combination with risk mitigation, assure that the sick get the coverage they need without charging the healthy unfairly high premiums,” the outline said.

But the plan doesn’t specifically say how much of the grant must go to offset costs for risk mitigation. A state could set up a program like a high-risk pool, which covers the highest medical claims for sick patients.

A major critique from Democrats and health policy analysts is that there needs to be adequate funding for high-risk pools, a major point of contention during GOP efforts to repeal Obamacare last year.

The Trump administration also recently backed a lawsuit from Texas and 18 other states that seeks to eliminate the law’s pre-existing condition protections.

The plan also seeks to expand use of health savings accounts and emphasizes that the block grants will not go to cover abortions.

The funding for the block grant would be based upon prior spending on Obamacare subsidies and the Medicaid expansion per state.

Officials with the group have previously said that states that didn’t expand Medicaid would not be left out of a higher block grant than states that did expand it under the law. The reason is that non-expansion states have to pay more tax credits to people who don’t get insurance through the expansion.

The consensus group’s plan is also similar to a bill touted by Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., last fall that sough to convert Obamacare funding into block grants.

It remains unclear whether the policy will get enough support in the Senate, where efforts collapsed last July when three GOP senators voted against a “skinny” repeal bill that repealed most of the law’s mandates.

The GOP has one fewer senator to work with this year after Democrat Doug Jones’ victory in the Alabama special election.

Right now the GOP cannot afford to lose one senator as it has a 51-vote majority and Vice President Mike Pence can break a 50-50 tie. Sen. John McCain, R-Ariz., has been out recuperating from brain cancer treatments.

Graham has said that he is working to revive Obamacare repeal, but it remains unclear if enough of his colleagues are on board.

But Sen. Rand Paul, R-Ky., has said he is opposed to a block grant similar to the Graham-Cassidy plan because it just shifts around Obamacare’s funding without actually repealing the law.

Centrist GOP Sens. Lisa Murkowski of Alaska and Susan Collins of Maine both voted against Obamacare repeal bills last summer, as did McCain in a dramatic “no” vote last July.

Democrats immediately pounced on the new plan. House Minority Leader Nancy Pelosi tweeted that while “the Trump Administration is savagely separating children from their mothers, Republicans quietly unveiled a new plan to repeal the Affordable Care Act, demonstrating that they’ll stop at nothing until people’s health care is destroyed.”