Eleven health-care bill changes aimed at wooing moderates and the far-right
In an effort to coax skeptics within the party to support an overhaul of federal health-care law, House Republican leaders introduced nine amendments on Monday night and three more on Thursday. The House originally was to have voted on the legislation, called the American Health Care Act, on Thursday, but the chamber’s leaders postponed it for lack of support. At the urging of President Trump, they announced Thursday night that they would hold the vote on Friday. It remains unclear whether these changes are persuading the dozens in their ranks who have been saying they oppose the legislation or have serious concerns. Given that all Democrats are expected to vote against it, the legislation will fail if more than 22 House Republicans vote against it.
The legislation faces resistance from both moderates within the House GOP and the most conservative faction. As a result, the bill’s authors have proposed to alter parts of the bill in ways to appeal to one camp or the other — and even offered a change specifically targeting a handful of representatives from Upstate New York. Here’s how the bill has changed:
The three amendments added Thursday:
AHCA
For conservatives
Eliminate federal requirement that plans be comprehensive
Starting next year, would get rid of the ACA’s requirement that health plans sold to individuals and small businesses must cover 10 “essential health benefits,” including care for pregnant women and newborns, mental health treatment and maternity care, among other things. The bill would, instead, direct each state to determine the basic health benefits that insurance must include. Some states would be free to keep the 10 required under the ACA, cut the list, or not establish any minimum coverage. As a result, health plans in parts of the country could be sold that are skimpier and less expensive.
For moderates
Increase aid to states for maternity and newborn care
AHCA
Would add maternity and newborn care to a list of ways that states could use federal money they would receive through a “Patient and State Stability Fund” that the legislation would create.The delay in the repeal of the Medicare tax on wealthy Americans would provide $15 billion to be used for this purpose.
For moderates
Delay repeal of Medicare tax on wealthy Americans
AHCA
This change would leave in place for another six years a 0.9 percent Medicare tax the ACA created on people who earn above $200,000 if filing individually, or $250,000 if married and filing jointly. The repeal would now take effect in 2023.
The eight amendments added Monday:
AHCA
For conservatives
End Medicaid expansion sooner
Obamacare's Medicaid expansion allowed people with incomes up to 138 percent of the federal poverty line to enroll in the program in participating states. The Republicans’ bill would, within a few years, end the generous federal funding the ACA provides states to help cover people in this Medicaid expansion.
The AHCA would allow states to expand Medicaid until the end of 2019, but an amendment would mean that only states that had expanded their programs by March 2017 could receive the higher amount of federal Medicaid money provided under current law.
AHCA
For conservatives
Optional work requirement for Medicaid
States could choose to require able-bodied adults to prove that they are working or looking for work to qualify for Medicaid benefits. Children, pregnant women, parents of young children, some students and disabled people would be exempted.
[ Trio of GOP proposals would overhaul Medicaid dramatically, starting with job requirement]
For moderates
$85 billion in additional aid for older Americans
AHCA
An amendment would try to free up federal money to provide more financial help to Americans ages 50 to 64, who typically have higher health costs than younger people and could face big insurance price increases under the AHCA. (Those 65 or older are typically eligible for help under Medicare.) The amendment does not spell this out, however, and the House GOP leadership is hoping the Senate would further alter the legislation to include this help.
[ House Republicans unveil changes to their health-care bill]
For moderates
Increased inflation factor for elderly and disabled
AHCA
Under the legislation, the way the government helps pay for Medicaid would be profoundly changed. Instead of covering a fixed percentage of the costs of each person on the Medicaid rolls in a given state, the government would begin to pay a fixed sum of money per person, with the sum changing from year to year based on the rate of medical inflation. The amendment would slightly increase the yearly inflation adjustment for people on Medicaid who are elderly or disabled — but not for other adults or for children.
AHCA
For conservatives
Medicaid block grants option
States could have an alternative to the per-person funding — a block grant, which is a fixed amount of federal funding, not tied to the number of enrollees. In exchange, states that chose block grants would be freed from federal standards that define the people states must include in their Medicaid programs and the medical benefits that must be covered.
[ Trio of GOP proposals would overhaul Medicaid dramatically, starting with job requirement]
AHCA
For conservatives and the health-care industry
Accelerating the expiration of the ACA’s taxes
The amendment would move up, from 2018 to 2017, the repeal of several taxes that help pay for provisions of the ACA. They include taxes on health insurers, prescription and over-the-counter drugs, medical devices and tanning beds, as well as a tax on Americans with higher incomes.
A delay in the legislation of the ACA’s “Cadillac tax” on high-cost employer plans would be extended by a year from 2025 to 2026.
AHCA
For New Yorkers
Upstate New York counties to give less to state for Medicaid
New York helps fund its Medicaid program through county property tax revenue. The amendment incentivizes the state to change this by blocking federal reimbursement of Medicaid funds collected by counties, which Rep. Chris Collins (R-N.Y.) said amounts to $2.3 billion. The amendment excludes New York City.
AHCA
For Illinoisans
Increase federal Medicaid funding for Illinois
According to lllinois’ GOP delegation, Center for Medicare and Medicaid Services Director Seema Verma said the state would be allowed to adjust its 2016 expense report. That means, the state would receive more money when Medicaid switches to per-person funding.
Sent from my iPhone
No comments:
Post a Comment